慢性阻塞性肺疾病急性加重患者血清降钙素原水平变化的临床意义

Clinical Significance of PCT Level Change in AECOPD

目的动态监测降钙素原(PCT)水平,指导抗生素在AECOPD患者中的使用,减少不必要的抗生素暴露时间。方法入选当日血清PCT≥0.5μg/L的27例AECOPD患者为PCT组,同期随机选择30例AECOPD患者为常规治疗组。PCT组根据血清PCT水平决定抗生素的使用,如PCT<0.25μg/L停用抗生素;常规治疗组根据患者临床症状、体温、WBC计数、CRP水平决定抗生素的使用。主要观察指标为抗生素的使用天数、抗生素费用等。结果 PCT组的抗生素使用天数(10.30±2.76)d,常规治疗组(13.47±1.38)d,PCT组的抗生素费用(3525.76±1162.96)元,常规治疗组(4706.72±803.04)元,两组患者差异有显著性(P<0.01)。结论 PCT水平能指导抗生素在AECOPD患者中的使用,减少不必要的抗生素暴露时间。

Objective To monitor PCT level dynamically and guide the use of antibiotics in AECOPD in an attempt to reduce the unnecessary antibiotic exposure time. Methods We chose on the same day 27 cases of AECOPD whose blood serum PCT≥0.5 μg/L as PCT group, and then chose 30 cases of AECOPD as routine therapy group. In the PCT group, the serum PCT level was taken as standard of using the quantity of antibiotic, and when the PCT〈0.25 μ g/L, we stopped using antibiotic. In the routine therapy group, the antibiotic treatment was carried out according to clinical symptoms, body temperature, WBC account, and CRP level. The main observation indexes were the days and cost of using antibiotic and so on. Results There were （10.30 ± 2.76）d in the days of using antibiotic in the PCT group, and （13.47 ±1.38） d in the routine therapy group, and in the cost of using antibiotic, the PCT group showed （3525.76 ±1162.96） yuan, and the routine group, （4706.72 ± 803.04） yuan, with a significant difference between the two groups （P〈0.01）. Conelusion PCT level can guide the use of an- tibiotics in AECOPD, which is meaningful to reduce the unnecessary antibiotic exposure time.