降钙素原动态值对血液病伴不明原因发热患者合理使用抗菌药物的价值

Effect of PCT Dynamic Value on Antibacterial Drug Use in Patients with Hematonosis Complicating Infection of Fever of Unknown Origin

目的监测血液病伴不明原因发热(FUO)患者的血清降钙素原(PCT)动态水平值,探讨临床优化感染用药及其使用价值。方法将96例患者随机分为试验组和对照组。试验组57例采用快速半定量法(PCT-Q)检测,观察临床优化感染用药前后PCT动态水平值的变化;对照组39例采用常规治疗,比较两组患者PCT动态水平值的变化。结果血清PCT动态水平值与患者感染细菌严重程度有关。试验组的抗菌疗程、住院天数、抗菌药使用强度(AUD)和药品不良反应等均明显低于对照组(P<0.01)。结论临床药师利用PCT动态水平值,对血液病伴不明原因发热感染者的鉴别判断、早期诊断及临床抗菌药短期优化治疗有应用价值。

Objective To monitor the dynamic value of serum procalcitonin （PCT） in the patients with hematonosis complicating fever of unknown origin（FUO） and to discuss the optimization of clinical infection medication and its use value. Methods 96 cases of hematonosis complicating FUO were randomized into the experimental group and the control group. The experimental group（57 cases） was detected by the rapid semiquantitative method （PCT- Q）. The change of PCT dynamic values before and after optimizing infection medication was observed. The control group（39 cases） adopted the routine therapy. The changes of PCT dynamic values were compared between the two groups. Results The dynamic level of serum PCT value was related with the severity of bacterial infection. The antibacterial treatment course, hospitalization days, use intensity of antibacterial drugs and adverse drug reactions in the experimental group were significantly lower than those in the control group, the difference was statistically significant （P 〈 0.01）. Conclusion Clinical pharmacists using the PCT dynamic values has the application value in the identification diagnosis, early diagnosis and the short-term optimization therapy in hematonosis complicating infection of UFO.