血清肝素结合蛋白动态监测对指导慢性阻塞性肺疾病急性加重期抗感染治疗的应用价值

Application value of dynamic monitoring of serum heparin-binding protein in guiding anti-infective treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨血清肝素结合蛋白动态监测对指导慢性阻塞性肺疾病急性加重期(AECOPD)抗感染治疗的应用价值。方法选取我院2021年10月至2022年5月收治的92例AECOPD患者随机分为对照组和观察组,各46例。对照组由临床医师根据其常规检测指标、症状表现以及病情进展情况确定用药方案。观察组患者在检测常规指标的基础上,动态监测HBP水平变化,并据此调整抗生素的应用方案。比较两组患者抗生素使用情况、住院时间及住院费用情况。结果观察组抗生素使用率及使用持续时间≥10天的患者比例均低于对照组(69.57%vs 89.13%、12.50%vs 73.17%,均P<0.05);治疗后14d,两组患者的总有效率差异无统计学意义(93.48%vs 86.96%,P>0.05),但观察组的显效率显著高于对照组(58.70%vs 36.96%,P<0.05);观察组患者的总住院时长和总住院费用均显著低于对照组[(8.93±3.14)天vs(13.76±4.25)天、(6647.23±493.74)元vs(8583.75±537.68)元,均P<0.05]。结论动态监测AECOPD患者的血清HBP水平,有助于指导临床合理应用抗生素,可缩短住院时长、减轻患者医疗负担,效果确切且安全,值得临床推广应用。

Objective To explore the value of dynamie monitoring of senum heparin binding protein(HBP)in guiding the anti infective treatment of acute exacerbation of chronie obstructive pulmonary disease(AECOPD).Methods 92 patients with AECOPD admitted to our hospital from October 2021 to May 2022 were randomly divided into a control group and an observation group,with 46 cases in each group.In the control group,the clinician deter-mined the medication plan according to the routine detection index,symptom manifestation,and disease progression.In the observation group,the application plan of antibiotics was adjusted according to the change in HBP level.The use of antibiotics,hospitalzation time,and hospitalization expenses were compared between the two groups.Results The use rate of antibiotics and the propotion of patients whose use duration≥10d in the observation group were lower than those in the control group(69.57%ts 89.13%,12.50%1s 73.17%,allP<0.05);On the 14th day after treatment,there was no significant diference in the total ffective rate between the two groups(93.48%u 86.96%,P>0.05),but the significant ffective rate of the observation group was significantly higher than that of the control group(58.70%ts 36.96%,P<0.05);The total length of hospital stay and total cost of hospitalization in the observation group were significantly lower than those in the control group[(8.93±3.14)d us(13.76±4.25)d,(6647.23±493.74)yuan 1s(8583.75±537.68)yuan,all P<0.05].Conclusion Dynamic monitoring of serum HBP levels in AECOPD patients was helpful in guiding the rational use of antibiotics,shortening the length of hospitalization,and reducing the medical burden of patients.The ffct was accurate and safe,and it was worthy of clinical application.