降钙素原指导社区获得性肺炎用药的Meta分析  

Procalcitonin-guided therapy in patient with Community-acquired Pneumonia：a meta-analysis of randomized controlled trials

作　　者：刘晓帆[1] 胡苏萍[1] 陈国忠[1] 陈雪芹[1] 

机构地区：[1]武汉大学人民医院呼吸内科,430060

出　　处：《临床内科杂志》2012年第11期756-759,共4页Journal of Clinical Internal Medicine

摘　　要：目的探讨降钙素原（PCT）指导社区获得性肺炎的用药时机和标准。方法计算机检索Medline、Embase、万方数据库和中国知网中关于降钙素原和社区获得性肺炎的随机对照试验，同时筛选纳入文献的参考文献。对文献质量进行严格评价和资料提取，对符合质量标准的随机对照试验进行Meta分析。结果5项研究符合纳入标准，包括1613名社区获得性肺炎患者。抗生素暴露率在PCT组（根据血清PCT浓度而决定）较对照组（按惯例接受抗生素治疗）低[RR=0．90，95％CI（0．87，0．92），P〈0．01]。PCT组可以缩短抗生素使用时间[SMD=-1．41d，95％CI（-1．45，-0．90），P〈0．01]。结论PCT对指导社区获得性肺炎患者的抗生素治疗有重要的意义，可以缩短治疗时间，减少抗生素的滥用。Objective To evaluate systematically the effectiveness of procalcitonin（PCT）-guided therapy in comparison with traditional therapy in patient with Community-acquired Pneumonia. Methods Five randomized controlled trails（ 1613 patients） were included for statistical analysis by the Cochrane collaboration＇ s RevMan 5.0 software. Results Exposure rate of antibiotics is lower compared to tradi- tional group [ RR = 0.90,95 % CI （0.87,0.92）, P 〈 0. 00001 ]. PCT-guided therapy was associated with a significant reduction in duration of antibiotic therapy [ SMD = - 1.41d,95% CI（ - 1.45, - 0.90） ,P 〈 0. 00001 ]. Conclusions An algorithm based on PCT measurements would allow a more judicious use of antibiotics than currently traditional treatment of patients with Community-acquired Pneumonia. It can re- duce the use of antibiotics and appear to reduce the treatment time.

关 键 词：社区获得性肺炎 降钙素原 抗生素 

分 类 号：R563.1[医药卫生—呼吸系统]