降钙素原指导慢性阻塞性肺疾病急性加重期患者的抗菌药物使用

目的探讨降钙素原在指导慢性阻塞性肺疾病急性加重期(AECOPD)患者抗菌药物使用方面的价值。方法选取2014年3月至2015年9月航天中心医院呼吸科诊治的AECOPD患者184例,采用随机数字表法分为对照组和观察组两组,各92例。对照组患者根据临床经验实施抗菌药物治疗,观察组患者根据血清降钙素原浓度实施抗菌药物治疗。结果观察组患者治疗后降钙素原水平较治疗前显著降低(P0.05)。观察组患者治疗后降钙素原、半年内再次急性加重发生率、半年内再住院率低于对照组(P0.05)。观察组患者抗菌药物使用时间、抗菌药物费用、住院时间、住院费用少于对照组(P0.05)。两组患者治疗总有效率、住院病死率比较,差异无统计学意义(P0.05)。结论 AECOPD患者血清降钙素原显著升高,参考降钙素原水平有助于优化抗菌药物的使用。

Procalcitonin in guiding antibiotic use in patients with AECOPD *

Objective To investigate the value of procalcitonin in guiding the antibiotic use in acute exacerbation of chronic ob-structive pulmonary disease(AECOPD) .Methods A total of 184 patients with AECOPD in our hospital from March 2014 to Sep-tember 2015 were selected and divide into two groups by the random number table method .Ninety-two cases in the control group received the antibiotic therapy according to clinical experience .Ninety-two cases in the observation group was implemented the anti-biotic therapy according to serum procalcitonin level .Results Compared with before treatment ,the procalcitonin level after treat-ment in the observation group was decreased significantly (P<0 .05) .The procalcitonin level after treatment ,occurrence rate of a-cute exacerbation within six months and re-hospitalization rate within six months in the observation group were lower than those in the control group(P<0 .05) .The antibiotic use time ,antibiotic expenses ,hospitalization time and hospitalization cost in the obser-vation group were less than those in the control group(P<0 .05) .The total effective rate and hospitalization mortality rate had no statistical difference between the two groups (P>0 .05) .Conclusion Serum procalcitonin is significantly increased in the patients with AECOPD .Procalcitonin can be used for the optimized use of antibiotics .