血清降钙素原监测对小儿细菌感染性肺炎合理使用抗生素的指导  

Clinical value of serum procalcitonin for the guidance of rational use of antibiotics in children with bacteria infectious pneumonia

作　　者：周会霞[1] 杨广龙[2] 李银华[3] 

机构地区：[1]湖北省天门市第一人民医院医院感染管理科,湖北天门431700 [2]湖北省天门市第一人民医院心内科,湖北天门431700 [3]湖北省天门市第一人民医院儿科,湖北天门431700

出　　处：《现代医学》2017年第3期401-405,共5页Modern Medical Journal

摘　　要：目的:探讨血清降钙素原(PCT)监测对小儿细菌感染性肺炎合理使用抗生素的指导价值。方法:采用前瞻性、随机、对照研究方法,将2013年5月至2016年2月医院收治的284例细菌感染性肺炎患儿随机分为PCT指导组142例和标准治疗组142例,PCT指导组根据血清PCT含量指导抗生素使用,标准治疗组根据临床指导标准使用抗生素,比较两组抗生素使用率、抗生素使用时间、不良反应发生率、不良反应持续时间、住院率、住院时间及安全性。结果:PCT指导组抗生素使用率显著低于标准治疗组,抗生素使用时间、不良反应持续时间显著短于标准治疗组,两组比较差异具有统计学意义(P<0.05)。病情亚组分析显示,PCT指导的轻症亚组抗生素使用率、抗生素使用时间均显著低于标准治疗组(P<0.05),PCT指导的重症亚组抗生素使用时间显著低于标准治疗组(P<0.05);感染途径亚组分析显示,PCT指导的非社区获得性肺炎(CAP)患儿和CAP患儿抗生素使用率、抗生素使用时间均显著低于标准治疗组,组间比较差异具有统计学意义(P<0.05)。结论:血清PCT指导小儿细菌感染性肺炎抗生素使用,能够显著减少抗生素使用率,缩短抗生素使用时间,对规范抗生素使用、降低病原菌耐药性具有重要意义。Objective： To explore the clinical value of serum procalcitonin（PCT） for the guidance of rational use of antibiotics in children with bacteria infectious pneumonia. Methods： With a prospective, randomized, controlled study, a total of 284 cases of bacteria infectious pneumonia children treated in hospital from May 2013 to February 2016 were randomly divided into PCT guidance group 142 cases and standard treatment group 142 cases. According to the serum PCT content, PCT guidance group acquired rational use of antibiotics, standard treatment group used antibiotic according to the clinical guidelines, the antibiotics use rate, antibiotic use time, adverse reactions rate, adverse reaction duration time, hospitalization rate, hospitalization time and safety of two groups were compared.Results： The antibiotics use rate in the PCT guidance group was significantly lower than that in the standard treatment group, the antibiotics duration time and adverse reaction duration time were significantly less than those in the standard treatment group, and the difference between the two groups was statistically significantly （P 〈 0.05 ）. In illness condition aspects, the antibiotics use rate, antibiotics duration time in PCT guidance mild sub group were significantly lower than those in the standard treatment group （ P 〈 0. 05 ）, antibiotics duration time in PCT guidance of severe sub group of was significantly lower than that in the standard treatment group （ P 〈 0.05 ）. In infection pathway aspects, antibiotics duration time and antibiotics using rate in PCT guidance of non CAP and CAP were significantly lower than those in the standard treatment group, and the difference were statistically significantly （ P 〈 0.05 ）. Conclusion： Under the guidance of serum PCT in children with bacterial infectious pneumonia, the use of antibiotics, the use time of antibiotics are significantly reduced. Serum PCT has an important significance in regulate the use of antibiotics and reduce the resistance of path

关 键 词：降钙素原 细菌感染性肺炎 抗生素 儿童 

分 类 号：R725.6[医药卫生—儿科]