降钙素原在指导慢性阻塞性肺疾病急性加重期抗菌治疗中的价值  

Value of procalcitonin in guiding the treatment for acute exacerbation of chronic obstructive pulmonary disease

作　　者：李小春[1] 段炼[1] 贾云峰[1] 余良[1] 向益君 

机构地区：[1]中国第十九冶金建设公司职工医院呼吸内科,四川攀枝花617023

出　　处：《临床医学》2013年第2期21-23,共3页Clinical Medicine

摘　　要：目的评价降钙素原(PCT)在指导慢性阻塞性肺疾病急性加重期(AECOPD)抗菌治疗中的价值。方法本研究纳入62例AECOPD患者,随机分成PCT组和常规治疗组。PCT组根据血清PCT水平决定抗生素的使用;常规治疗组根据患者临床症状、体温、白细胞计数、C-反应蛋白水平决定抗生素的使用。主要观察指标为抗生素的使用时间、住院时间、临床有效率、加重例数和死亡例数等。结果 PCT组的抗生素使用时间多分别在7～10 d;而常规治疗组大部分在2周甚至更长,差异有统计学意义(P<0.05),两组患者住院时间相比差异有统计学意义(P<0.05),两组临床有效率、病死率和加重例数比较差异无统计学意义(P>0.05)。结论 PCT具有指导AECOPD抗菌治疗的作用,减少不必要的抗生素暴露时间。Objective To evaluate the value of procalcitonin（PCT）in guiding the treatment for acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods Sixty-two patients with AECOPD were randomly divided into PCT group and routine therapy group.In PCT group,the patients received antibiotic treatment according to the serum level of PCT.In routine therapy group,the antibiotic treatment was carried out according to clinical symptoms,body temperature,WBC account,and CRP level.The length of antibiotic exposure,clinical recovery rate,length of hospitalization,and death and exacerbation rates were recorded.Results The length of antibiotic exposure in PCT group was 7-10 days,while that in standard-therapy group was more than 2 weeks,and the difference was significant（P0.05）.There was a significant difference of the length of hospitalization between the two groups（P0.05）.Conclusion Procalcitonin guidance for AECOPD can reduce the unnecessary antibiotic exposure time.

关 键 词：慢性阻塞性肺疾病 抗菌治疗 降钙素原 

分 类 号：R563.9[医药卫生—呼吸系统]