降钙素原在慢性阻塞性肺疾病急性加重期合并细菌感染诊治中的价值  

The diagnostic and therapeutic value of procalciton in acute exacerbation of chronic obstructive pulmonary disease with bacterial infection

作　　者：魏丽娟[1] 郑平 崔娜[1] WEI Li-juan;ZHENG Ping;CUI Na(Department of Respiratory Medicine,Beijing Sixth Hospital,Beijing 100007,China)

机构地区：[1]北京市第六医院呼吸科,北京100007 [2]解放军总医院第八医学中心原航天城门诊部内科,北京100094

出　　处：《中国卫生检验杂志》2020年第11期1330-1333,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析降钙素原(PCT)对慢性阻塞性肺疾病急性加重期(AECOPD)合并细菌感染的诊断和抗菌药物治疗的价值。方法选取196例AECOPD患者为研究对象。分为细菌感染组113例及非细菌感染组83例,完善PCT等检查,PCT>0.25 ng/ml时给予抗菌素治疗。观察两组PCT及血清炎性指标变化,分析两组抗菌药物使用情况。分析细菌感染组亚组(痰细菌阳性组、肺炎组及支气管扩张组)PCT变化及不同PCT水平抗菌药物使用情况。结果细菌感染组PCT及白细胞总数、中性粒细胞百分比、CRP均高于非细菌感染组(P<0.05)。抗菌药物使用率、使用种类、累计DDD数及抗菌治疗时间、成本、联合用药率均高于非细菌感染组(P<0.05)。细菌感染组亚组分析肺炎组PCT高于痰细菌阳性及支气管扩张组(P<0.05)。PCT轻度升高组抗菌药物使用种类、人均累计DDD数及抗菌治疗时间、联合用药率均低于中度、重度升高组(P<0.05)。结论PCT是AECOPD细菌感染的预测指标,合并肺炎者升高更显著。PCT有助于了解AECOPD细菌感染程度,对是否应用抗菌药物、抗菌时间、抗菌药物的消耗量、抗菌药物成本及联合用药方面有指导意义。Objective To analyze the value of PCT in the diagnosis and treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with bacterial infection.Methods A total of 196 patients with AECOPD were selected as the study objects.The patients were divided into bacterial infection group(113 cases)and non-bacterial infection group(83 cases).PCT was detected and antibiotics were given when PCT was more than 0.25 ng/ml.The changes of PCT,serum inflammatory indexes and the usage of antibiotics in the two groups were analyzed.The changes of PCT and the use of antibiotics at different PCT levels in bacterial infection subgroups(sputum positive subgroup,pneumonia subgroup and bronchiectasis subgroup)were also analyzed.Results PCT,WBC,percentage of neutrophils and CRP in bacterial infection group were higher than those in non-bacterial infection group(P<0.05).The rate,types,accumulated DDDs,treatment time,cost and combination rate of antibiotics used in bacterial infection group were all higher than those used in non-bacterial infection group(P<0.05).PCT in pneumonia subgroup was higher than that in sputum bacteria positive subgroup and bronchiectasis subgroup(P<0.05).The types,accumulated DDDs per capita,treatment time and combination rate of antibiotics used in slight increased PCT group were lower than those used in moderate and severe increased PCT group(P<0.05).Conclusion PCT is a predictor to AECOPD with bacterial infection,and it is especially higher in AECOPD patients with pneumonia.PCT is also conducive to find out the degree of bacterial infection in AECOPD patients,and can guide whether to use antibacterial agents,and predict the treatment time,consumption,cost and combination rate of antibacterial agents.

关 键 词：降钙素原 慢性阻塞性肺疾病急性加重期 细菌感染 诊治价值 

分 类 号：R563.9[医药卫生—呼吸系统]