血清PCT水平检测在老年慢性阻塞性肺疾病并肺部感染抗感染治疗中的作用

Role of PCT Levels Detection in the Anti-Infective Therapy on the Elder Patients with Chronic Obstructive Pulmonary Disease and Lung Infections

目的:探讨血清降钙素原(PCT)水平检测在老年慢性阻塞性肺疾病(COPD)并肺部感染抗感染治疗中的作用。方法:选取2013年2月-2014年3月本院患有COPD且经病原学确诊有肺部感染的老年住院患者86例,按随机数字表法分为PCT组(n=52)和经验治疗组(n=34)。PCT组采用免疫发光法检测患者血清PCT水平,并根据PCT水平应用抗生素治疗;经验治疗组根据临床经验和临床症状应用抗生素治疗。观察比较两组患者抗生素使用天数、住院天数、临床有效率、功能状态评分、二重感染率、加重及死亡率等指标的差异。结果:PCT组的抗生素使用天数、住院天数和二重感染率均明显少于经验治疗组(P<0.05)。两组的临床有效率、功能状态评分、加重及死亡例数比较差异均无统计学意义(P>0.05)。结论:PCT水平可指导老年慢性阻塞性肺疾病并肺部感染患者应用抗生素,有利于减少抗生素的应用和缩短住院时间,降低二重感染率,避免抗生素使用过多而产生细菌耐药性。

Objective：To discuss the role of PCT levels detection in the anti-infective therapy on the elder patients with COPD and lung infections.Method：86 elder patients with COPD and lung infections were selected and divided into the PCT group（n=52） and the empirical treatment group（n=34）, patients on the were detected and antibiotic therapy according to the PCT levels, patients on the empirical treatment group were treated according to the clinical experience and clinical symptoms. The anti-infection treatment time, length of stay, clinical efficiency, functional status score, super-infection rate, course increase and mortality of both group were observed and compared. Result：The antiinfection treatment time, length of stay and super-infection of the PCT group were statistically shorter than the empirical treatment group（P〈0.05）. And the clinical efficiency, functional status score, course increase and mortality of the two groups were not statistically significant（P〉0.05）.Conclusion：The levels of PCT can be used to guide the anti-infective therapy of elder patients with COPD and lung infections, conducive to reduce the use of antibiotic and shorter hospital stays, reduce super-infection rate, can avoid bacterial resistance arising from excessive use of antibiotics.