血清降钙素原检测在治疗慢性阻塞性肺疾病并下呼吸道感染中的意义  

Clinical significance of detection of procalcitonin for treating chronic obstructive pulmonary disease combined with lower respiratory tract infection

作　　者：易高[1] 方向明[1] 林纯意[1] 沈露[1] 黄静怡[1] 何耀军[1] 

机构地区：[1]广州医科大学附属第五医院呼吸内科,广东广州510700

出　　处：《中国现代医药杂志》2016年第2期30-33,共4页Modern Medicine Journal of China

摘　　要：目的探讨血清降钙素原（PCT）检测在治疗慢性阻塞性肺疾病（简称慢阻肺）并下呼吸道感染中的意义。方法将2014年8月～2015年9月来我院就诊的110例慢阻肺并下呼吸道感染患者随机分为对照组和实验组,每组55例;对照组患者由临床医师根据经验结合其症状给予抗生素治疗,实验组患者根据体内血清PCT水平变化调整抗生素的使用,当血清PCT≥0.15μg/L时使用抗生素,血清PCT〈0.15μg/L时不使用或停用抗生素。比较两组患者抗生素使用率、抗生素使用时间、住院时间、二重感染、死亡率和临床有效率等指标。结果经过抗生素治疗后,实验组患者总有效率为96.36%,与对照组的87.27%比较,差异无统计学意义（χ2=3.0253,P〉0.05）。实验组患者抗生素使用率为41.82%,抗生素使用时间为（6.7±2.5）d,住院时间为（12.1±5.9）d,均显著低于对照组的72.73%、（10.9±3.2）d及（18.9±5.6）d,差异有统计学意义（P〈0.05）。两组白细胞计数[（8.3±1.8）×109/L vs（8.6±1.7）×109/L]、二重感染发生率（3.64%vs 9.09%）及死亡率（1.82%vs 5.45%）比较,差异无统计学意义（P〉0.05）。结论对慢阻肺并下呼吸道感染患者行血清PCT检测,不仅能避免抗生素不合理使用和滥用,防止细菌耐药性的产生,还可缩短患者的住院时间,降低二重感染率。Objective To explore the clinical significance of detection of serum procaleitonin （PCT） for treating chronic obstructive pulmonary disease combined with lower respiratory tract infection. Methods 110 cases with chronic obstructive pulmonary disease combined with lower respiratory tract infection from Aug 2014 to Sep 2015 in our hospital were randomly di- vided into research group and control group with 55 cases in each group. Patients in control group received antibiotics according to physician＇s experience and the symptoms of the patients. Patients in research group were treated with antibiotics according to serum PCT levels, antibiotic was used when PCT level was more than 0.15μg/L and discouraged when PCT level was less than 0.15μg/L. The antibiotics usage rate, length of antibiotic exposure, length of hospital stay, double infection, mortality and clini- cal efficient rate were compared between the two groups. Results The clinical effective rate of research group was 96.36%, compared with the control group （87.27%）, there was no statistically significant difference （X2=3.0253, P〉0.05）. There were statistically significant differences in the ratio of antibiotics usage （41.82% vs 72.73%）, the average time of antibiotics use [（6.7±2.5）d vs （10.9±3.2）d] and the length of hospital stay [（12.1±5.9）d vs （18.9±5.6）d] between the two groups. However, there were no differences in white blood cell count [（8.3±1.8）×109/L vs （8.6±1.7）×109/L], double infection incidence （3.64% vs 9.09%）, and mortality （1.82% vs 5.45%） between the two groups. Conclusion Detecting PCT level in patients with chronic obstructive pulmonary disease combined with lower respiratory tract infection could effectively reduce the irrational use of antibi- otics, the double infection and the length of hospital stay.

关 键 词：血清降钙素 检测 慢性阻塞性肺疾病 下呼吸道感染 抗生素 

分 类 号：R563.9[医药卫生—呼吸系统]