贵州医科大学学报

2015, v.40;No.183(12) 1374-1376+1380

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血清降钙素原水平指导AECOPD抗菌药物应用的价值
Significance of Serum Procalcitonin in Guiding the Application of Antimicrobial drugs in AECOPD Patients

苗云霞;阎磊;
MIAO Yunxia;YAN Lei;The Fifth People's Hospital of Zhengzhou City;The People's Hospital of Henan Province;

摘要(Abstract):

目的:探讨慢性阻塞性肺疾病(COPD)患者血清降钙素原(PCT)在慢性阻塞性肺疾病急性加重期(AECOPD)抗菌药物应用的指导意义。方法:住院治疗AECOPD患者126例,根据患者入院当日血清PCT水平分为PCT组(n=66,PCT≥0.25 mg/L)和常规治疗组(n=60,PCT<0.25 mg/L),PCT组患者根据患者血清PCT水平调整治疗的抗菌药物,常规治疗组根据医生经验、白细胞(WBC)计数和血清C反应蛋白(hs-CRP)水平调整治疗药物,比较两组患者入院当日和出院时全血WBC计数,血清PCT、hs-CRP水平,住院时间、治疗疗程、抗菌药物费用及临床疗效。结果:两组患者治疗后血清PCT、hs-CRP水平和WBC计数低于治疗前(P<0.05),PCT组患者治疗后血清PCT、hs-CRP水平和WBC计数低于常规治疗组(P<0.05);PCT组患者住院时间、治疗疗程、抗菌药物费用较常规治疗组明显降低,而PCT组治疗效果明显优于常规治疗组(P<0.05);结论:血清PCT作为指导AECOPD患者抗菌药物应用的有效指标,可以减少住院时间和抗菌药物费用,提高临床治疗效果。
Objective: To investigate the guidance significance of procalcitonin( PCT) in antibiotic usage of patients with acute exacerbation of chronic obstructive pulmonary disease( AECOPD). Methods: A total of 126 cases with AECOPD were divided into PCT group( n = 66 cases,PCT≥0. 25 mg /L) and conventional treatment group( n = 60,PCT < 0. 25 mg / L) according to serum PCT levels on adminssion day. Antimicrobial agents was adjusted according to the serum PCT levels in PCT group and on the basis of doctor experience,WBC counts and hs-CRP levels in conventional treatment group.The levels of PCT,hs-CRP and WBC,hospitalization time,treatment course,cost of antibacterial drugs and clinical effect were compared between the two groups. Results: The PCT,hs-CRP levels and WBC counts after threatment were obviously lower than those before treatment in the two groups( P < 0. 05),and those in PCT group were lower than conventional treatment group( P < 0. 05). Hospitalization time,treatment course in PCT group were shorter and the cost of antibacterial drugs were lower than conventional treatment group( P < 0. 05). The treatment effects in PCT group was significantly better than treatment group( P < 0. 05). Conclusion: Serum PCT,as an effective indicator for guiding the application of antibacterial drugs in patients with AECOPD,can reduce hospitalization time and save the cost of antibacterial drugs,as well as improve the effect of clinical treatment.

关键词(KeyWords): 降钙素原;慢性阻塞性肺疾病急性加重期;抗菌药物;白细胞计数;C反应蛋白
procalcitonin;acute exacerbation of chronic obstructive pulmonary disease;antibacterial drugs;white blood cell count;C-reactive protein

Abstract:

Keywords:

基金项目(Foundation): 河南省科技厅基础与前沿项目(142300410075)

作者(Author): 苗云霞;阎磊;
MIAO Yunxia;YAN Lei;The Fifth People's Hospital of Zhengzhou City;The People's Hospital of Henan Province;

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DOI: 10.19367/j.cnki.1000-2707.2015.12.023

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