血清降钙素原水平测定在急性上呼吸道感染合理使用抗生素的临床意义  

Clinical significance of serum procalcitonin level for rational use of antibiotics in patients with acute upper respiratory tract infection

作　　者：徐志锋[1] 余梅娟[1] 林俊明[1] 区秀凤[1] 吴秀琼[1] 文丽杰[1] 

机构地区：[1]江门市中心医院,529070

出　　处：《国际医药卫生导报》2014年第14期2067-2071,共5页International Medicine and Health Guidance News

基　　金：江门市科技局科研立项项目（2013062）

摘　　要：目的 探讨血清降钙素原（Procalcitonin,PCT）水平在诊治急性上呼吸道感染患者中的临床意义.方法 选取2013年1月至2013年11月江门市中心医院急诊科诊治的急性上呼吸道感染患者199例,随机分为2组：常规组98例和PCT组101例.在相同常规诊疗的基础上,常规组按照抗生素指南进行治疗,PCT组加测血清PCT水平,根据PCT水平指导抗生素治疗.观察2组的临床疗效、退热时间、抗生素使用率、疗程和抗生素不良反应发生率;比较2组的抗生素费用和总费用.采用t检验和x2检验进行统计学分析.结果 PCT组患者的抗生素使用率（51.49％）、抗生素疗程（3.01±0.77）d、抗生素的费用（159.98±188.17）元、总费用（880.42±349.16）元均低于常规组的90.82％、（4.37±0.62）d、（228.71±147.85）元、（975.22±403.02）元,差异有统计学意义;PCT组的临床有效率89.11％、退热时间（3.29±1.45）d与常规组临床有效率92.86％、退热时间（3.40±1.69）d相比,差异无统计学意义.结论 急性上呼吸道感染患者首诊时进行血清PCT水平检测对合理使用抗生素有重要指导意义.Objective To explore the clinical significance of serum procalcitonin （PCT） level in the diagnosis and treatment of patients with acute upper respiratory tract infection.Methods 199 patients with acute upper respiratory tract infection treated at Jiangmen central hospital from Jan 2013 to Nov 2013 were divided into a conventional group（n=101） and a PCT group（n=98）.The conventional group was treated with antibiotic according to the antibiotic guidance,while the PCT group with antibiotic according to serum PCT levels.Both groups were also treated with routine therapy.The clinical efficacies,defervescence times,ratio of antibiotics usage,courses of antibiotics treatment and incidences of adverse reaction in both groups were observed.The cost of antibiotics and total cost were compared between the two groups.Results The ratio of antibiotics usage,course of antibiotics treatment,cost of antibiotics,and total costs were 51.49%,（3.01 ± 0.77） d,（159.98 ± 188.17） yuan,and （880.42 ± 349.16） yuan in the PCT group and were 90.82%,（4.37 ± 0.62） d,（228.71 ± 147.85） yuan,and （975.22 ± 403.02） yuan in the conventional group,with statistical differences （P 〈 0.05）.There were no significant differences in clinical efficacy and defervescence time between the PCT group and conventional group（89.1 1% vs.92.86%,[3.29 ± 1.45] d vs.[3.40 ± 1.69] d）.Conclusions Serum PCT level is useful for guiding antibiotics usage in the patients with acute upper respiratory tract infection.

关 键 词：急性上呼吸道感染 血清降钙素原 抗生素 

分 类 号：R56[医药卫生—呼吸系统]