降钙素原监测在社区获得性肺炎治疗中的临床应用价值

摘要

Objective To investigate application value of the serum procalcitonin(PCT)in the treatment of community acquired pneumo-nia(CAP). Methods 80 cases were included in the observation group(PCT monitoring group)and the control group,respectively. The appli-cation of antibiotics and hospitalization were compared between the two groups. The observation group was divided into the severe pneumonia and mild pneumonia group,the blood culture positive group and the blood culture negative group. The serum PCT levels were compared in the observa-tion group. The correlations of PCT to pneumonia severity index(PSI),CURB - 65 score were evaluated. Results Days of antibiotics application and the rate of combination application of antibiotics in the observation group were shorter and lower than those in the control group( P ﹤ 0. 05). The hospitalization time,hospitalization costs were significantly lower than the control group( P ﹤ 0. 05). The serum PCT level in severe pneumo-nia patients was significantly higher than that in mild pneumonia patients( P ﹤ 0. 05). In the observation group,the serum PCT level was higher than ordinary pneumonia group( P ﹤ 0. 05). In the observation group,the serum PCT level in blood culture positive group was(7. 1 ± 2. 4)ng/ml,which was significantly higher than that of blood culture negative group(mean 2. 5 ± 1. 3)ng/ ml( P ﹤ 0. 05). The serum PCT levels were positively correlated to PSI( r = 0. 561,P ﹤ 0. 05),CURB - 65 score( r = 0. 689,P ﹤ 0. 05). Conclusion The serum PCT level can reflect the degree of inflammation in CAP patients. PCT level is guiding to the rational use of antibiotics,and that reduce medical costs. It could be used as an effective indicator in prognosis.%目的探讨血清降钙素原监测在治疗社区获得性肺炎（CAP）中的临床应用价值。方法 CAP 患者160例，随机分为观察组[降钙素原（PCT）监测组]和对照组（常规治疗）各80例，比较两组间抗生素应用及住院情况；将观察组分为重症肺炎组和普通肺炎组、血培养阳性组和血培养阴性组，比较两组血清 PCT 水平；评价 PCT 与肺炎严重程度指数（PSI）、CURB -65评分的相关性。结果观察组较对照组抗生素应用疗程短、联合用药的比率降低（ P ﹤0.05），观察组住院时间、住院费用较对照组明显减低（ P ﹤0.05）。观察组中重症肺炎组 PCT 浓度高于普通肺炎组（ P ﹤0.05）。观察组中血培养阳性组 PCT 均值为（7.1±2.4）ng/ ml，明显高于血培养阴性组均值（2.5±1.3）ng/ ml（ P ﹤0.05）。PCT 与 PSI（ r =0.561，P ﹤0.05）、CURB -65评分（ r =0.689，P ﹤0.05）经均呈正相关。结论 PCT 能反映 CAP 患者炎症程度的轻重，监测 PCT 有利于合理应用抗生素、减少医疗费用，并对判断预后具有一定的临床应用价值。