抗人T细胞兔免疫球蛋白对降钙素原的影响  

Effect of anti-human T cell rabbit immunoglobulin on procalcitonin

作　　者：徐柳莎 同格乐 冷彦圻 贺俊保 赵玮 郭诗瑶 吴芳 XU Liusha;TONG Gele;LENG Yanqi;HE Junbao;ZHAO Wei;GUO Shiyao;WU Fang(Beijing Ludaopei Hospital Pharmacy,Beijing 101102;Beijing Ludaopei Hospital Transplantation,Beijing 101102;Beijing Ludaopei Hospital Nutrition,Beijing 101102)

机构地区：[1]北京陆道培医院药剂科,北京101102 [2]北京陆道培医院移植科,北京101102 [3]北京陆道培医院营养科,北京101102

出　　处：《当代医药论丛》2022年第22期7-10,共4页

摘　　要：目的:探讨PCT在ATG使用期间对细菌感染特异性的预测价值,以及在此期间指导抗生素使用的临床意义。方法:采取回顾性分析的方法,收集我院2018年8月1日至2020年12月31日所有使用ATG的患者共279例。将其分为A、B两组,A组用药前PCT高于正常值(19例),B组用药前PCT值正常(260例)。两组患者均应用了抗生素。统计并比较使用ATG前3天、用药后第1天至第9天两组患者的PCT检测值。结果:B组患者使用ATG前后PCT检测值具有显著性差异(P<0.05);ATG使用后即使3天内无其他明确感染指征,当日起即可引起PCT检测值迅速升高,第2天达到峰值,随后缓慢回落,截止用药后第9天,PCT检测值仍未恢复正常。A组患者因用药前已有细菌感染,存在其他感染指征,故使用ATG后PCT检测值亦始终高于正常水平。结论:应用ATG会导致PCT检测值升高,故在此期间不可将该指标的升高作为细菌感染的特应性指标及使用抗生素的依据。对于ATG使用前无明确细菌感染指征的患者,如无其他明确的感染依据及指征,无需使用抗生素,特别是不提倡升级使用特殊级抗生素或盲目增加抗生素的联合使用。Objective:To investigate the predictive value of PCT on bacterial infection specificity during ATG use and its clinical significance in guiding antibiotic use during this period.Methods:A total of 279 ATG patients in our hospital from August 1,2018 to December 31,2020 were collected by retrospective analysis.The patients were divided into two groups:Group A and group B,the PCT of group A was higher than the norm al value(19 cas es)and group B was normal(260 cases).Both groups were given antibiotics.The PCT values of the two groups were statistically compared 3 days before ATG treatment and 1 to 9 days after ATG treatment.Results:The PCT values of group B before and after ATG were significantly different(P<0.05);Even if there was no other clear indication of infection within 3 days after the use of ATG,the PCT test value increased rapidly from the day before,reached the peak value on the second day,and then fell slowly.By the end of the 9th day after the use of ATG,the PCT test value still did not return to normal.The PCT test value of group A was always higher than the normal level due to the existing bacterial infection and other indications of infection before the use of ATG.Conclusion:The application of ATG can lead to the increase of PCT detection value,so the increase of this index should not be used as the atopic index of bacterial infection and the basis for the use of antibiotics during this period.For patients with no clear indication of bacterial infection before the use of ATG,there is no need to use antibiotics if there is no other clear evidence and indication of infection.In particular,upgrading the use of special class antibiotics or blindly increasing the combined use of antibiotics is not recommended.

关 键 词：抗人T细胞兔免疫球蛋白 降钙素原 细菌感染 抗生素 

分 类 号：R979.5[医药卫生—药品]