降钙素原监测在重症胰腺炎患者抗生素治疗中的指导价值  

Guide of procalcitonin for antibiotic use in patients with severe acute pancreatitis

作　　者：瞿嵘[1] 罗裕锋[1] 梁小仲[1] 凌云[1] 郭智[2] 

机构地区：[1]广东省惠州市中心人民医院重症医学科,516001 [2]北京军区总医院血液科

出　　处：《中国医药》2014年第10期1498-1500,共3页China Medicine

基　　金：广东省医学科研基金（A2013772）

摘　　要：目的 探讨血清降钙素原监测在重症胰腺炎患者抗生素治疗中的指导意义.方法 将2012年10月至2013年9月于广东省惠州市中心人民医院入住重症监护病房的71例重症急性胰腺炎患者按随机数字表法分为血清降钙素原监测指导应用抗生素的试验组或无降钙素原指导预防性抗生素治疗的对照组.对抗生素治疗时间、住院治疗时间、住院费用等进行统计分析.结果 试验组抗生素治疗时间为（10.9±2.8）d,住院时间（16.7±4.0）d;对照组抗生素治疗时间为（16.1 ±2.5）d,住院时间（23.8±7.6）d,2组比较差异有统计学意义（P＜0.05）,试验组住院费用也明显低于对照组[（153 726±16 578）元比（187 740±15 935）元,P＜0.05].结论 血清降钙素原监测对重症胰腺炎患者的抗生素治疗有指导作用,有利于减少抗生素的使用时间、缩短住院时间并降低住院费用.Objective To investigate the clinical use of procalcitoniu（PCT） for guiding antibiotic therapy in patients with severe acute pancreatitis（SAP）.Methods A total of 71 patients with confirmed severe acute panereatitis were enrolled from October 2012 to September 2013 at ICU of Huizhou Maneipal central Hospital.Patients were randomly assigned to either a PCT-guided （study group） or a prophylactic antibiotic therapy （control group）.The antibiotic therapy time,hospitalization days and hospitalization cost were analyzed.Results The duration of antibiotic therapy and hospitalization were significantly shorter in the study group than in the control group [duration of antibiotic therapy （10.9 ± 2.8） days vs （16.1 ± 2.5） days,P 〈 0.05],and [duration of hospitalization,（16.7 ± 4.0） days vs （23.8 ± 7.6 days）,P 〈 0.05].The cost of hospitalization was significantly lower in the study group than in the control group [（153 726 ± 16 578） yuan vs （187 740 ± 15 935） yuan,P 〈0.05].Conclusions Monitoring of PCT is a helpful and safe tool for guiding antibiotic treatment in patients with severe acute pancreatitis.This may contribute to an optimized antibiotic regimen with beneficial effects on microbial resistance and costs in hospital.

关 键 词：重症胰腺炎 感染 降钙素原 抗生素治疗 

分 类 号：R657.51[医药卫生—外科学] R453.2[医药卫生—临床医学]