降钙素原在指导肺部感染优化抗菌治疗的临床意义

Guiding value of procalcitonin in antibacterial treatment of pulmonary infection

目的研究降钙素原(PCT)在指导肺部感染抗菌治疗策略及优化抗生素使用中的临床意义。方法入选ICU肺部感染60例,分为PCT指导组和常规治疗组。PCT指导组血清PCT≥0.5μg/L时使用抗生素,PCT<0.5μg/L则停用抗生素;常规治疗组按照抗生素使用指南给予治疗。观察并比较患者临床有效率及治疗30 d内未使用抗生素时间、感染复发率、死亡率、机械通气时间、多重耐药菌感染的发生率。结果两组治疗30 d内未使用抗生素时间、多重耐药菌感染的发生率比较,差异有统计学意义(t=10.13,χ2=30.24,P均<0.05);两组临床有效率、30 d内死亡率、感染复发率和机械通气时间比较,差异均无统计学意义(χ2分别=16.59、19.89、23.21,t=0.25,P均>0.05)。结论 PCT指导抗菌治疗策略在肺部感染患者中是安全有效的,能够减少抗生素过度使用,减少抗菌药物暴露时间及多重耐药菌感染的几率。

objective To evaluate the guiding value of procalcitonin（PCT） in antibacterial treatment of pulmonary infec-tion. Methods Sixty patients with pulmonary infection were divided into PCT guide group and control group. In the PCT guide group, antibiotics was used when PCT≥0.5μg/L while was stopped when PCT〈0.5μg/L. In the control group, the use of antibiotics was based on the antibacterial guidelines. The clinical efficiency, no-antibiotics time, infection recur-rence rate, mortality, ventilation time and multidrug resistance infection incidence in 30-day treatment were observed. Results There was significant difference between PCT guide group and control group in no-antibiotics time and multidrug resistance infection incidence （t=10.13,χ2=30.24,P〈0.05）. But there was no significant difference in the clinical efficien-cy, mortality, infection recurrence rate and ventilation time （χ2=16.59,19.89,23.21,t=0.25,P〉0.05）. Conclusion PCT plays a safe and effective role in guiding antibacterial treatment, which may reduce the overuse and exposure duration of antibiotics as well as the multidrug resistance infection rate.