监测恶性肿瘤化疗前细菌感染患者血清降钙素原水平对抗菌药使用的影响

Monitoring of Bacterial Infection in Patients With Malignant Tumor Before Chemotherapy Serum Procalcitonin Levels on The Impact of Antimicrobial Drug Use

目的:探讨监测恶性肿瘤患者化疗前并发细菌感染血清降钙素原(PCT)水平对临床优化抗菌药使用的价值。方法:114例患者分成观察组和对照组。对照组(45例)予常规治疗,跟据患者临床症状体征选用抗菌药;观察组(69例)监测血清PCT水平、超敏C反应蛋白(hsCRP)、血常规及血培养的变化,据此制订优化抗菌药方案。观察2组抗菌药疗程、住院天数、抗菌药费用、抗菌药使用强度(AUD),以及二重感染和药品不良反应(ADR)发生情况。结果:观察组患者血清PCT水平与患者细菌感染严重程度有关。观察组的抗菌药疗程、住院天数、抗菌药费、AUD,以及二重感染和ADR等指标均优于对照组,差异有统计学意义(P<0.05或0.01)。结论:监测PCT动态值对恶性肿瘤患者化疗前细菌感染的诊断及临床抗菌药短期优化治疗有实用价值。

Objective：Discussion of monitoring in patients with malignant tumor chemotherapy before concurrent bacterial infection of serum procaleitonin （ PCT ） levels on clinical optimization of antimierobial drug use value. Methods： 114 cases were divided into observation group and control group. The control group （45 cases） was treated with convention- al therapy, according to the clinical symptoms of patients with selection of antibacterial drugs; The observation group （69 cases） monitoring serum PCT level, super sensitive c-reactive protein （hsCRP）, blood routine and the change of blood cul- ture , pursuant to which the formulation of to optimize antibacterial drug scheme. Observation two groups antibacterial treat- ment, hospitalization days, antibacterial drug costs, antibacterial use density （AUD） , as well as the incidence of superin- feetion and adverse drug reactions （ADR）. Results：The observation group patients serum PCT levels with bacterial infec- tion in patients with severe degree. The Observer Group antibacterial drug treatment, the number of days of hospitalization, antimierobia] drugs costs, AUD, as well as the superinfeetion and ADR ete indicators are better than the control group, the difference was statistically significant （P 〈 0.05 or 0.01 ）. Conclusion： Monitoring of PCT dynamic value on malignant tumor before chemotherapy patients with bacterial infection before the diagnosis and clinical antibacterial short-term optimal treatment has the practical value.