血清降钙素原测定对合理应用抗生素治疗AECOPD的作用

目的评价降钙素原(procalcitonin,PCT)对AECOPD合并的细菌感染临床应用价值。方法 2009年6月至2010年5月在我院呼吸科入院AECOPD患者109例,随机分成PCT组(n=52)和常规治疗组(n=57),常规治疗组按常规治疗方法使用抗生素进行治疗,PCT组通过血清PCT测定来指导抗生素使用,比较两组抗生素使用时间、使用率、临床有效率、患者住院费用、住院时间及抗生素治疗结束后两组患者炎性指标(白细胞总数、中性粒细胞数、CRP)之间的差异。结果两组治疗后PCT组患者白细胞总数、中性粒细胞数、CRP与常规治疗组差异无统计学意义,两组治疗后白细胞总数、中性粒细胞数、CRP均较治疗前下降,同时抗生素使用时间、抗生素使用率、患者住院费用及住院时间常规组与PCT组差异有统计学意义,PCT组抗生素使用率明显低于常规治疗组。结论在AECOPD治疗中参考PCT水平应用抗生素可以达到有效治疗效果,而避免过度使用抗生素。

Using PCT to determine antibiotic treatment for AECOPD

Objective To evaluate the use of procalcitonin(PCT) levels to guide the antibiotic treatment strategies on patients with acute exacerbation of colonic obstructive pulmonary disease(AECOPD).Methods 109 patients with AECOPD in the department of respiratory medicine from June 2009 to May 2010 were randomly divided into the PCT group(51 patients) and the routine therapy group(58 patients).In the PCT group,the serum PCT levels were referenced to the quantity of antibiotic to administer;in the routine therapy group,antibiotics were administered according to regular treatment standers.Metrics compared between the two groups were duration and frequency of using antibiotic,the cost and length of staying in hospital,and the difference of inflammatory indexes(total white blood cells,n etofilos absolutes and CRP).Results The inflammatory indexes in the two groups all declined with no significant difference.The duration and frequency of using antibiotic,the costs and days in hospital had significant differences in the two groups.The frequency of using antibiotic in PCT group was lower than the routine therapy group.Conclusion PCT levels can guide the use of antibiotic in treating AECOPD to reduce the unnecessary antibiotic exposure.