血清降钙素原治疗慢性阻塞性肺疾病急性加重期抗菌疗效分析

目的探讨降钙素原（ PCT）水平分级在慢性阻塞性肺疾病急性加重期（ AECOPD）抗菌治疗中的临床使用价值。方法将106例AECOPD患者随机分成PCT组（n=54）和对照组（n=52）,PCT组根据血清PCT水平决定抗生素的使用,对照组则根据临床经验、患者的临床症状决定抗生素的治疗方案。观察2组患者的临床有效率、住院时间、住院总费用、抗菌疗程、二重感染例数、抗生素使用人数、抗生素费用、功能状态评分、C-反应蛋白水平以及1年随访期间AECOPD发生人数。结果两组临床有效率、住院时间、功能状态评分、C-反应蛋白水平以及1年随访期间AECOPD发生人数与对照组相比,差异无显著性（P＞0.05）；但PCT组的住院总费用、抗菌疗程、二重感染例数、抗生素使用人数以及抗生素费用均显著低于对照组（P〈0.05）。结论 PCT可指导AECOPD抗菌治疗,减少抗生素的使用,降低二重感染机会。

Clinical Significance of Serum Procalcitonin for Antibiotic Treatment inPatients with Acute Exacerbations of Chronic Obstructive Pulmonary

ObjectiveTo explore the clinical value of procalcitonin in guiding the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease.Methods106 patients with AECOPD accepting treatment in our hospital were divided randomly into PCT group(n=54) and the control group(n=52),in PCT groups the use of antibiotics was dependent on the PCT serum levels of the patients,while in control group the use of the antibiotics was based on clinical experience and symptoms of patients.The clinical effective rate,length of hospital stay,total cost,antibiotics treatment period,superinfection cases,antibiotics usage cases,cost of antibiotics,performance status score,C-reactive protein,patients of exacerbation within 1 year were compared between two groups.ResultsNo statistical difference was observed between two groups in clinical effective rate,hospital stay,Performance Status Score,C-reactive protein,patients of exacerbation within 1 year between two groups(P>0.05);but statistically difference existed in the total cost,antibiotics treatment period,superinfection cases,antibiotics usage cases,cost of antibiotics between two groups(P<0.05).ConclusionPCT could serve as guidance for antibiotic treatment in patients with AECOPD,optimizing the use of the antibiotics and reducing the risk of superinfection.