降钙素原用于脓毒症抗感染治疗指标的Meta分析  

Application of procalcitnin in treatment of sepsis:a meta-analysis

作　　者：苏家琼 马兴龙[2] 王国贤[2] 杨中福[1] 谭心[3] SU Jia-qiong;MA Xing-long;WANG Guo-xian;YANG Zhong-fu;TAN Xin(Zunyi First People's Hospital,Zunyi,Guizhou 563002,China)

机构地区：[1]遵义市第一人民医院急诊科,贵州遵义563002 [2]遵义市第一人民医院重症医学科,贵州遵义563002 [3]遵义市第一人民医院医院检验科,贵州遵义563002

出　　处：《中华医院感染学杂志》2020年第5期671-675,共5页Chinese Journal of Nosocomiology

基　　金：贵州省卫生计生委科学技术基金资助项目(GZWJWKJ2016-1-059)。

摘　　要：目的系统评价基于降钙素原(PCT)水平的抗菌药物应用对重症监护室(ICU)脓毒症患者临床结局的影响.方法建立研究团队,确定与研究主题相关的关键词和主题词,检索国内外中英文相关文献数据库,通过前期的资料阅读和讨论,对检索到的题录逐一阅读并筛选,收集与本次研究相关的题录信息,下载全文提取符合标准的数据信息,并结合软件(Stata 12.0)进行Meta分析.结果最终纳入文献14篇(中文7篇,英文7篇),共2949例患者.结果显示,与对照组相比,PCT组指导抗菌药物使用时间[SMD=-1.13,95%CI(-1.40,-0.85),P<0.001]、ICU住院时间[SMD=-0.52,95%CI(-0.83,-0.22),P<0.001]明显缩短,28 d病死率[OR=0.75,95%CI(0.60,0.93),P=0.011]组间差异有统计学意义,而医院病死率[OR=0.74,95%CI(0.48,1.15),P=0.184]组间比较无统计学差异.结论PCT指导的抗菌药物应用能够有效缩短抗菌药物使用时间和住院时间,降低患者的28 d病死率,而对医院病死率未见明显影响.OBJECTIVE To systematically evaluate the effect of procalcitonin-guided antibiotic therapy on clinical outcomes of patients of intensive care unit(ICU).METHODS A research team was established to determine the keywords and subject words related to the research topic,the relevant Chinese and English literatures were retrieved from databases at home and abroad,the retrieved literatures were reviewed and screened,the information of subjects in relevant to the research was collected,the whole articles were downloaded to extract the data that met the criteria,and the meta-analysis was performed by using Stata 12.0software.RESULTS A total of 14pieces of articles,including 7Chinese articles and 7English articles,were included in the study,involving 1949patients.The time of use of antibiotics and length of ICU stay of the PCT group were respectively[SMD=-1.13,95%CI(-1.40,-0.85),P<0.001]and[SMD=-0.52,95%CI(-0.83,-0.22),P<0.001],significantiy shorter than those of the control group,the 28-day mortality rate was[OR=0.75,95%CI(0.60,0.93),P=0.011];however,the hospitalized mortality rate was[OR=0.74,95%CI(0.48,1.15),P=0.184],and there was no between-group difference.CONCLUSIONThe procalcitonin-guided antibiotic therapy can effectively shorten the time of use of antibiotic and length of hospital stay and reduce the 28-day mortality rate of the patients,but it has less remarkable effect on the hospitalized mortality rate.

关 键 词：降钙素原 抗菌药物 脓毒症 META分析 

分 类 号：R631[医药卫生—外科学]