血浆降钙素原监测指导肝硬化合并自发性细菌性腹膜炎治疗的临床效果研究  

Clinical effect study on plasma procalcitonin monitoring in the guidance of treatment of liver cirrhosis combined with spontaneous bacterial peritonitis

作　　者：左彦[1] 张允健[1] 陈远博[1] 雷平光[1] 

机构地区：[1]深圳市宝安区松岗人民医院消化内科,深圳518105

出　　处：《中国当代医药》2015年第9期32-34,共3页China Modern Medicine

基　　金：广东省深圳市宝安区科技计划项目(2013218)

摘　　要：目的探讨降钙素原（PCT）在肝硬化合并自发性细菌性腹膜炎（SBP）患者抗菌治疗中的指导意义。方法将本院2012年1月-2014年12月消化内科收治的96例诊断肝硬化合并SBP的患者作为研究对象,随机分成PCT组和对照组,各48例,在相同常规治疗的基础上,PCT组根据PCT水平决定抗菌药物的启用、用量及停用,对照组由医生根据临床经验结合患者症状决定抗菌药物的使用,观察两组患者治疗过程的PCT水平、疗效、抗菌药物疗程和费用、住院时间及住院费用。结果入院第1天至出院时,两组患者存活病例PCT水平逐步降低,死亡病例的PCT水平逐步升高,两组存活病例入院第7天和入院第10天PCT水平比较差异有统计学意义（P〈0.01）;两组存活患者出院时PCT水平比较差异无统计学意义（P〉0.05）;两组存活患者疗效比较差异无统计学意义（P〉0.05）;PCT组抗生素使用时间和住院时间明显短于对照组,抗生素费用及住院费明显少于对照组,差异有统计学意义（P〈0.05）。结论 PCT指导下进行肝硬化并SBP的抗菌治疗能减少抗菌药物的使用,缩短住院天数,降低费用。Objective To explore the guiding significance of procalcitonin（PCT） in the antibiotic therapy in patients with liver cirrhosis and spontaneous bacterial peritonitis（SBP）. Methods Ninety-six patients diagnosed as liver cirrhosis combined with SBP accepted treatment in our department of gastroenterology from January 2012 to December 2014 were selected as research objects and evenly divided into PCT group and control group in random,each group of 48 cases.On the basis of the same conventional treatment,initial use,dose,and stopped use of antibiotics determined by PCT level were applied in PCT group.In the control group,use of antibiotic was determined by clinical experience and patient′s symptoms.The PCT level in the process of treatment was observed as well as curative effect,course of treatment in antibiotic and its cost,hospital stay and hospitalization expense. Results From the first day of admission to being discharged from hospital,PCT level gradually decreased in the survived cases in both groups,while the PCT level in death cases gradually increased.There were statistical difference with PCT level in the 7thand 10 thdays of admission in survived cases between two groups（P〈0.01）.On being discharged from hospital,PCT level between two groups didn′t display statistical difference（P〉0.05）.There was no statistical difference in curative effect in these survived patients between two groups（P〉0.05）.The course of treatment,hospital stay in PCT group was shorter than that in control group respectively,cost of antibiotics and hospitalization expense in PCT group was less than that in control group respectively,with statistical difference（P〈0.05）. Conclusion Liver cirrhosis combined with SBP guided by PCT for antibiotic therapy can reduce the usage of antibiotics,shorten patient′s hospital stay and decrease cost.

关 键 词：降钙素原 肝硬化 自发性细菌性腹膜炎 抗菌治疗 

分 类 号：R446.1[医药卫生—诊断学]