降钙素原监测在指导脑卒中合并肺部感染患者抗生素使用中的作用  

Effect of procalcitonin on the use of antibiotics in patients with cerebral stroke complicated with pulmonary infection

作　　者：弓自玉[1] 廖之明[2] 冯慧[3] 

机构地区：[1]广元市精神卫生中心门诊办公室,四川广元628000 [2]广元市精神卫生中心门诊综合服务部,四川广元628000 [3]广元市精神卫生中心医保科,四川广元628000

出　　处：《现代医学》2016年第2期194-197,共4页Modern Medical Journal

摘　　要：目的:探讨脑卒中合并肺部感染患者血清降钙素原(PCT)水平监测对指导临床抗生素使用的作用。方法:选取住院治疗的100例脑卒中合并肺部感染患者,采用随机数字表法分为研究组和对照组各50例,研究组患者应用PCT指标指导抗生素治疗,对照组依据我国抗生素使用指南使用抗生素治疗,记录两组患者治疗效果的差异。结果:研究组的住院时间、住院费用、抗生素治疗时间、抗生素治疗费用均显著低于对照组(P<0.05),治疗30 d后两组患者的病死率、NIHSS评分、Barthel指数比较差异均无统计学意义(P>0.05),两组患者治疗后第1、第3、第7天及停用抗生素时的PCT和C反应蛋白(CRP)水平差异均无统计学意义(P>0.05),两组患者治疗过程中各类抗生素使用率差异无统计学意义(P>0.05)。结论:通过监测脑卒中合并肺部感染患者血清PCT水平指导临床抗生素应用,能够达到与常规抗生素应用相同的效果,同时可以缩短治疗时间和降低费用。Objective： To investigate the effect of serum level of procalcitonin（ PCT） in the guidance of antibiotic treatment on patients with cerebral apoplexy complicated with pulmonary infection. Methods： One hundred stroke patients complicated with pulmonary infection were randomly assigned into study group and control group with 50 in each group. The antibiotic treatment was conducted under the guidance of serum level of PCT in the study group,while in the control group the antibiotics treatment was performed based on National Antibiotics Use Guide. The differences of the therapeutic effects between the two groups were documented. Results： The stay and cost of hospitalization and the time and cost of antibiotic treatment were significantly lower in the study group than those in the control group（ P 〈0. 05）. The mortality,NIHSS score and Barthel index after 30 days of the treatment showed no statistically significant difference（ P〉 0. 05） between the two groups. On the 1st,3rd and 7th day after treatment and discontinuation of antibiotics,the PCT and C-reactive protein（ CRP） levels were not significantly different（ P 〉0. 05） between the two groups. And the rate of all types of antibiotic use during treatment was not statistically significant different（ P〉 0. 05）. Conclusion： By monitoring the serum PCT levels of stroke patients complicated with pulmonary infection to guide the antibiotic treatment,the same therapeutic effects can be achieved as conventional antibiotic treatment,and it can also shorten the time and reduce the cost of treatment.

关 键 词：脑卒中 肺部感染 降钙素原 抗生素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]