血清降钙素原测定在支气管哮喘急性发作治疗中的应用

目的 研究血清降钙素原(PCT)检测在支气管哮喘急性加重患者治疗时抗生素使用中的指导作用.方法 选取2007年2月至2009年7月间复旦大学附属上海市第五人民医院的哮喘急性加重患者158例,随机(随机数字法)分配到两组:PCT指导治疗组77例(PCT组)和常规治疗组81例(对照组),检测血清PCT水平.在相同常规治疗基础上,对照组由经治医师按照抗生素使用指南决定是否使用抗生素,PCT组按照血清PCT水平决定是否使用抗生素,在血清PCT≥0.25 ng/mL时,进行抗生素治疗,PCT＜0.25ng/mL时,不予抗生素治疗.观察两组患者的抗生素使用率.采用t检验、x2检验及Mann-Whitney U检验进行统计学分析.结果 PCT组的抗生素使用率(45.4%)低于对照组(77.8%)(x2=17.51,P=0.000),两者预后没有明显差异.结论 支气管哮喘急性加重患者可在PCY指导下安全使用抗生素,能够降低抗生素使用率.

The value of serum procalcitonin in the treatment of acute exacerbation of asthma

Objective To evaluate the value of serum procalcitonin (PCT) in antibiotics used for the treatment of acute exacerbation of asthma. Method From February 2007 to July 2009, a total of 158 patients with asthma were randomly (random number) assigned to PCT group ( n = 77) or to control group ( n = 81 ). The PCT levels of all patients were measured. On the bases of routine treatment, the employment of antibiotics in control group was determined by the guidebook, and patients in the PCT group were treated with antibiotics guided by the levels of serum PCT. The antibiotics treatment was employed as PCT level ＞0.25 ng/mL, and was not employed as PCT level ＜ 0.25 ng/mL. The rates of antibioties employment were observed. Results The rate of antibiotics employment in PCT group (45.4%) was lower than that of the control group (77.8%) (x2 = 17.15,P =0.000). Conclusions PCT could be used safely as guidance of antibiotics employment for the treatment of patients with acute exacerbation of asthma, leading to appropriate use of antibiotcs.