血清降钙素原在AECOPD患者运用中的价值
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摘要
目的探讨血清降钙素原(PCT)在COPD急性加重期(AECOPD)优化抗生素应用中的价值。方法 80例患者随机分为观察组和对照组各40例,对照组根据经验使用抗生素,观察组根据血清PCT水平指导抗生素应用。结果两组有效率、住院时间及住院病死率相似(P>0.05);观察组抗菌药物疗程、住院费用及二重感染率均低于对照组,差异存在显著性(P<0.05)。治疗两周后患者功能状态评分较本组治疗前明显降低(P<0.05),但是两组间比较,差异无显著性(P>0.05)。结论 PCT具有指导AECOPD抗生素治疗的作用,有效防止抗生素过度使用。
Objective To investigate the value of procalcitonin( PCT) in optimization of antibiotics application in AECOPD patients. Methods 80 patients were selected and randomly divided into the observation group and the control group,40 patients in each group. The control group used antibiotics according to the doctors' experiences,while the observation group used antibiotics according to serum PCT level. Results There was no significant difference in clinical effective rate and duration of hospital stay( P > 0. 05). But the course of antibacterial treatment,the cost of hospital stay and incidence of dual infection was significantly lower in the observation group than in the control group( P < 0. 05). 2 weeks after the treatment,the functional status scores in the two groups decreased significantly when compared with those before the treatments( P < 0. 05),but the difference between the two groups showed no statistical significance( P > 0. 05). Conclusion PCT can guide the use of antibiotics,which can effectively prevent from excessive use of antibiotics.
Objective To investigate the value of procalcitonin( PCT) in optimization of antibiotics application in AECOPD patients. Methods 80 patients were selected and randomly divided into the observation group and the control group,40 patients in each group. The control group used antibiotics according to the doctors' experiences,while the observation group used antibiotics according to serum PCT level. Results There was no significant difference in clinical effective rate and duration of hospital stay( P > 0. 05). But the course of antibacterial treatment,the cost of hospital stay and incidence of dual infection was significantly lower in the observation group than in the control group( P < 0. 05). 2 weeks after the treatment,the functional status scores in the two groups decreased significantly when compared with those before the treatments( P < 0. 05),but the difference between the two groups showed no statistical significance( P > 0. 05). Conclusion PCT can guide the use of antibiotics,which can effectively prevent from excessive use of antibiotics.
引文
[1]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[S].中华结核和呼吸杂志,2007,30(1):1-7.
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[3]Lindenauer PK,Pekow P,Gao S,et al.Quality of care for patients hospitalized foracute exacerbations of chronic obstructive pulmonary disease[J]Ann Intern Med,2006,144(12):894-903.
[4]Mirjam Christ-Crain,Daiana Jaccard-Stolz,Roland Bingisser,et al.Effect of procalcitonin.guided treatment on antibiotic use and outcome in lower respiratory tract infections cluster-randomised.single-blinded intervention trial[J].The Lancett,2004,363(9409):600-607.
[5]江进平.降钙素原和C反应蛋白在支气管哮喘合并呼吸道感染中的诊断意义[J].中国医师进修杂志,2013,2(1):24-26.
[6]徐爱蕾,王为.降钙素原在感染性疾病中的应用进展[J].检验医学与临床,2011,8(18):2253-2254.
[7]宋毅,李婵,徐莉琼,等.COPD急性发作期超敏C-反应蛋白与降钙素原水平变化及相关性研究[J].临床肺科杂志,2012,17(9):1601-1602.
[8]Clec'h C,Fosse JP,Karoubi P,et al.Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock[J].Crit Care Med,2006,34(1):102-107.
[9]李小春,段炼,贾云峰,等.降钙素原在指导慢性阻塞性肺疾病急性加重期抗菌治疗中的价值[J].临床医学,2013,33(2):21-23.
[10]Lindenauer PK,Pekow P,Cao S,et al.Quality of care for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease[J].Ann Intern Med,2006,144(12):894-903.
[11]马晋,张颖,张杰,等.COPD急性加重期降钙素原与超敏C反应蛋白检测临床意义[J].临床肺科杂志,2011,16(12):1839-1840.
[2]Sethi S.Pathogenesis and treatment of acute exacerbations of chronic obstructive pulmonary disease[J].Semin Respir Crit Care Med,2005,26(2):192-203.
[3]Lindenauer PK,Pekow P,Gao S,et al.Quality of care for patients hospitalized foracute exacerbations of chronic obstructive pulmonary disease[J]Ann Intern Med,2006,144(12):894-903.
[4]Mirjam Christ-Crain,Daiana Jaccard-Stolz,Roland Bingisser,et al.Effect of procalcitonin.guided treatment on antibiotic use and outcome in lower respiratory tract infections cluster-randomised.single-blinded intervention trial[J].The Lancett,2004,363(9409):600-607.
[5]江进平.降钙素原和C反应蛋白在支气管哮喘合并呼吸道感染中的诊断意义[J].中国医师进修杂志,2013,2(1):24-26.
[6]徐爱蕾,王为.降钙素原在感染性疾病中的应用进展[J].检验医学与临床,2011,8(18):2253-2254.
[7]宋毅,李婵,徐莉琼,等.COPD急性发作期超敏C-反应蛋白与降钙素原水平变化及相关性研究[J].临床肺科杂志,2012,17(9):1601-1602.
[8]Clec'h C,Fosse JP,Karoubi P,et al.Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock[J].Crit Care Med,2006,34(1):102-107.
[9]李小春,段炼,贾云峰,等.降钙素原在指导慢性阻塞性肺疾病急性加重期抗菌治疗中的价值[J].临床医学,2013,33(2):21-23.
[10]Lindenauer PK,Pekow P,Cao S,et al.Quality of care for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease[J].Ann Intern Med,2006,144(12):894-903.
[11]马晋,张颖,张杰,等.COPD急性加重期降钙素原与超敏C反应蛋白检测临床意义[J].临床肺科杂志,2011,16(12):1839-1840.