急诊发热患者C反应蛋白和降钙素原指标指导抗菌药物选择的临床研究  

Clinical value of C-reactive protein and procalcitonin in guidance to antibiotics usage for acute febrile

作　　者：马爱华[1] 刘盼[1] 郅红蕾 何莹莹[1] 张小杰[2] MA Ai-hua LIU Pan ZHI Hong-lei HE Ying-ying ZHANG Xiao-jie(Zhengzhou Central Hospital,Zhengzhou Universit)

机构地区：[1]郑州大学附属郑州中心医院急诊科,河南郑州450007 [2]郑州大学附属郑州中心医务科,河南郑州450007

出　　处：《中华医院感染学杂志》2017年第4期774-776,780,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关资助项目(0134281655)

摘　　要：目的探讨急诊发热患者C反应蛋白、降钙素原等指标对使用抗菌药物的临床指导,为急诊发热的临床诊治提供借鉴和参考依据。方法选取2012年12月-2014年12月医院急诊收治的发热患者99例为研究对象,将其分为常规治疗组、CRP组和PCT组,各33例,常规治疗组以医生经验和患者临床指标检验结果为指导进行抗菌用药,CRP组根据CRP水平为指导进行抗菌用药,PCT组根据PCT水平为指导进行抗菌用药,观察和比较三组患者治疗后的抗菌药物使用时间、累计DDD数、抗菌药物费用、住院时间、住院费用和临床治疗总有效率。结果 CRP组和PCT组患者的抗菌药物使用时间、累计DDD数、抗菌药物费用、住院时间、住院费用等指标分别为(9.10±2.12)d和(9.11±2.18)d、(18.23±6.32)个和(18.89±7.01)个、(4123.08±128.02)元和(4208.27±182.34)元、(9.01±1.11)d和(8.89±1.02)d、(6932.34±172.34)元和(6980.32±193.34)元,均明显优于常规治疗组(14.32±6.32)d、(13.01±2.11)个、(6999.23±239.23)元、(12.34±4.33)d和(9443.23±342.34)元;CRP组和PCT组患者的临床治疗总有效率分别为93.94%和96.97%与常规治疗组90.91%水平相当,差异无统计学意义。结论在临床针对急诊发热患者实施临床诊治的过程中,以C反应蛋白和降钙素原指标指导抗菌药物的临床使用具有重要作用和意义,是临床实践过程中的理想选择。OBJECTIVE To explore the clinical value of C-reactive protein（CRP）and procalcitonin（PCT）in guidance to antibiotics usage for acute febrile patients so as to provide guidance for clinical diagnosis and treatment of the patients with acute fever.METHODS A total of 99 fever patients who were treated in the emergency department from Dec 2012 to Dec 2014 were recruited as the study objects and divided into the conventional treatment group,CRP group,and PCT group,with 33 cases in each group.The conventional treatment group was treated with antibiotics based on the doctor＇s experience and result of clinical laboratory test,the CRP group was treated with antibiotics according to the CRP level,and the PCT group was treated with antibiotics based on the PCT level.The time of use of antibiotics,cumulative DDDs,cost of antibiotics,days of hospitalization,hospitalization cost,and total effective rate of clinical treatment were observed and compared among the three groups of patients.RESULTS The time of use of antibiotics of the CRP group and PCT group were respectively（9.10±2.12）days and（9.11±2.18）days,significantly shorter than（14.32±6.32）days of the conventional treatment group;the cumulative DDDs of the CRP group and PCT group were respectively（18.23±6.32）and（18.89±7.01）,significantly higher than（13.01±2.11）of the conventional treatment group;the cost of antibiotics of the CRP group and PCT group were respectively（4123.08±128.02）yuan and（4208.27±182.34）yuan,significantly cheaper than（6999.23±239.23）yuan of the conventional treatment group;the length of hospitalization of the CRP group and PCT group were respectively（9.01±1.11）days and（8.89±1.02）days,significantly shorter than（12.34±4.33）days of the conventional treatment group;the hospitalization cost of the CRP group and PCT group were respectively（6932.34±172.34）yuan and（6980.32±193.34）yuan,significantly less than（9443.23±342.34）yuan of the conventional treatment group.The total effectiv

关 键 词：急诊发热 C反应蛋白 降钙素原 抗菌药物选择 

分 类 号：R446[医药卫生—诊断学]