降钙素原指导脓毒血症患者抗感染治疗的研究

Procalcitonin Guidance in Patients with Sepsis and Anti-infective Treatment

目的观察降钙素原(PCT)指导ICU中的脓毒血症患者的抗生素治疗是否能减少抗生素的使用。方法选择符合脓毒血症诊断标准的患者51例,前瞻、随机分为PCT指导治疗组(24例)和标准治疗组(27例)。分别使用PCT指导抗生素使用和标准治疗。记录病人住ICU天数、抗生素使用天数、抗生素相关副作用。结果降钙素原指导治疗组抗生素使用时间同标准治疗组比较明显减少(8.9±2.4[n=24]vs 12.4±2.8[n=27]d,P<0.05);抗生素相关副作用的发生PCT组均较对照组明显改善(21.1%[n=24],vs 29.8%[n=27],P<0.05);两组患者ICU住院天数没有显著差异(9.7±2.6[n=24]vs 10.5±2.7[n=27]d,,P>0.05)。结论降钙素原指导脓毒血症患者的抗感染治疗可以减少抗生素的疗程及副作用。

Objective To observe whether using a PCT algorithm can reduce antibiotic exposure.Methods 51 patients to comply with the diagnostic criterion of sepsis were randomized to administration of antibiotics based on a PCT algorithm with predefined cutoff ranges for initiating or stopping antibiotics（PCT group [n=24]） or according to standard guidelines（control group [n=27]）.The length of patient stay in ICU,duration and adverse effects of antibiotics were recorded.Results The mean duration of antibiotics exposure in the PCT vs control groups was lower in PCT group（8.9±2.4 [n=24] vs 12.4 ±2.8 [n=27] days,P0.05）.Antibiotic-associated adverse were less frequent in the PCT group（21.1% [n=24],vs 29.8% [n=27],P 0.05）.The length of two groups patient stay in ICU was similar（9.7±2.6 [n=24] vs 10.5±2.7 [n=27]days,P0.05）.Conclusion In patients with sepsis,a strategy of PCT guidance compared with standard guidelines resulted in lower antibiotic exposure,as well as lower rates of and antibiotic-associated adverse effects.