血清降钙素原对AECOPD抗生素使用的指导价值

摘要

Objective To investigate the guidance value of procalcitonin on antibiotic use in the treatment of AECOPD patients. Methods 63 patients with AECOPD were randomly divided into the PCT group (n=32) and the control group (n=31). The serum concentration of procalcitonin (PCT) were measured in all patients. On the base of similar routine treatment, the control group received antibiotics based on the physician 's decision, and the PCT group were treated with antibiotics according to serum PCT levels. The antibiotic treatment was applied when the level of PCT was higher than 0. 25ng/mL and stopped when the level of PCT was lower than 0. 25ng/mL. The duration of antibiotics use and hospital stay was observed. Results The duration of antibiotics use was shorter in the PCT group [7(5~11)d] than in the control group [13(7~16)d] (P=0. 03), and the cost of antibiotics in the PCT group was lower than that in the control group (P=0. 001). There was no significant difference in clinical efficacy and du-ration of hospital stay in the two groups (P>0. 05). Conclusion PCT guidance can reduce antibiotic duration and antibiotic cost in the treatment of AECOPD patients.%目的：研究血清降钙素原( PCT)检测在慢性阻塞性肺疾病急性加重期( AECOPD)对使用抗生素的指导价值。方法选取收治的AECOPD患者63例,随机分配成两组：PCT指导治疗组32例(简称 PCT组)和常规治疗组31例(简称对照组),检测血清PCT水平。在常规治疗的基础上,对照组按照临床抗生素使用指南决定抗生素疗程,PCT组按照血清PCT水平决定抗生素的使用,当血清PCT≥0．25ng/mL时,进行抗生素治疗,当PCT<0.25 ng/mL时,则停止使用抗生素。并观察两组患者抗生素的使用疗程,抗生素所用费用及住院时间。结果 PCT组抗生素疗程[7(5~11)d]短于对照组[13(7~16)d](P=0．03)；PCT组抗生素费用低于对照组(P=0．001),两组的住院时间及预后无明显差异。结论 AECOPD患者根据PCT水平使用抗生素,能够明显缩短抗生素的所用疗程,减少医疗费用。