血清降钙素原在老年社区获得性肺炎患者治疗中的价值

目的评估血清降钙素原监测在社区获得性肺炎老年患者治疗中的价值。方法选取2009年至2012年间住院的老年社区获得性肺炎患者180例,随机分为常规治疗组90例(常规组)和PCT指导治疗组90例(PCT组)。常规组由医师按我国CAP治疗指南决定抗生素治疗方案,PCT组按血清PCT水平决定是否使用抗生素。比较两组患者在住院时间、临床有效率、死亡率、抗生素使用率、抗生素疗程、抗生素费用的差异。结果两组患者的住院时间、临床有效率、死亡率差异无统计学意义(均为P>0.05),PCT组的抗生素使用率、抗生素疗程、抗生素费用均低于常规组(均为P<0.05)。结论与常规治疗组相比,老年CAP患者在PCT指导下使用抗生素可以减少抗生素使用量,缩短抗生素疗程,降低抗生素费用。

Value of serum procalcitonin in treatment of community - acquired pneumonia in elderly patients

Objective To study the value of serum proealeitonin （PCT）in treatment of community - acquired pneumonia in elderly patients. Methods A total of 180 elderly patients required hospitalization for CAP were randomly assigned into 2 groups ： standard therapy group （ standard group, n = 90） and PCT - guided group （PCT group, n = 90 ）. Standard group received antibiotics according to the guideline of the attending physicians and PCT group were treated with antibiotics according to~ serum PCT levels. Length of hospitalization, clinical efficacy, hospital mortality, rate of antibiotics use, antibiotic duration, costs of antibiotics were observed. Results length of hospitalization, clinical efficacy, hospital mortality were similar in 2 groups （ all P 〉 0. 05 ） ; rate of antibiotics use, antibiotic duration and costs of antibiotics of PCT group were lower than those of standard group （all P 〈 0. 05 ）. Conclusions PCT guidance offers an advantage over standard therapy in reducing antibiotic use, shorten antibiotic duration and lowering the costs of antibiotics in treatment of CAP in elderly patients.