血清降钙素原的检测对指导慢性阻塞性肺疾病急性加重期抗菌治疗价值的meta分析

Meta-analysis on the value of procalcitonin detection for guiding antimicrobial treatment of patients with acute exacerbation of chronic obstructive pulmonary disease

目的研究血清降钙素原(PCT)水平检测对指导慢性阻塞性肺疾病急性加重期(AECOPD)抗菌治疗的价值。方法采用meta分析法对国内外已经发表的相关文献进行合并分析,对PCT指导组和常规治疗组在疾病治疗的有效率、住院时间、抗菌药物费用等方面作比较。结果根据纳入和排除的标准,纳入meta分析的文献共6篇,分析结果显示PCT指导组与常规治疗组在疾病控制的有效率方面无差异,在住院时间及抗菌药物费用方面PCT指导组明显低于常规治疗组(P<0.05)。漏斗图对称,偏倚得到有效的控制。结论 PCT水平检测用于指导AECOPD抗菌治疗能降低住院时间及抗菌药物费用,本次meta分析结果稳定、可靠。

Objective To study the value of procalcitonin（PCT） detection for guiding antimicrobial treatment of patients with a- cute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods Meta analysis was applied on related demestic and foreign literatures which had been published. PCT-guiding group and conventional treated group were compared in treatment effi- cient,length of hospital stay, cost of antibiotic treatment, etc. Results According to the inclusion and exclusion criteria, there were 6 literatures included. The comparation between PCT-guide group and conventional treated group showed that there was no statisti- cally difference between PCT-guiding group and the conventional treatment group in the efficient of disease control, however, the duration of hospitalization and antibiotic costs were less in PCT-guiding group than conventional treatment group （P〈0.05）. Fun- nel plot was symmetry,and bias was effectively controlled. Conclusion Detection of PCT level to guide antibiotic therapy can re- duce the duration of hospitalization and antibiotic costs for patients with AECOPD,and the meta-analysis is stable and reliable.