监测降钙素原监测对三氯乙烯药疹样皮炎抗生素应用的意义

The significance of monitoring procalcitonin when applying antibiotics to trichlorethylene dermatitis

目的 探讨监测血清中降钙素原（PCT）对三氯乙烯（TCE）药疹样皮炎患者使用抗生素的意义.方法 以2006至2013年在我院住院的资料完整的TCE药疹样皮炎痊愈102例患者为研究对象,按照是否应用PCT监测,将TCE药疹样皮炎分为常规组和PCT组.常规组根据临床症状、实验室检查、影像学、细菌培养等情况给予抗生素治疗并决定抗生素疗程;PCT组在上述治疗的基础上,当PCT≥0.25 ng/ml时,给予抗生素治疗;当PCT＜0.25 ng/ml时,停用抗生素治疗.比较两组细菌感染部位分布、细菌种类、抗生素种类、平均住院时间、抗生素疗程的变化.结果 PCT组与常规组细菌感染部位分布、细菌种类、抗生素种类、平均住院时间的差异均无统计学意义（P＞0.05）;PCT组抗生素疗程[（20.58±7.53）d]明显短于常规组[（25.37±1 1.66）d],差异有统计学意义（P＜0.05）.结论 监测血清中PCT指导TCE药疹样皮炎患者的抗生素使用,在细菌感染情况相似的情况下,可以明显缩短抗生素使用的时间,避免抗生素使用的盲目性.

Objective To investigate the significance of monitoring procalcitonin （PCT） when applying antibiotics to trichlorethylene （TCE）-induced dermatitis.Methods One hundred and two patients who were hospitalized and recovered from TCE-induced dermatitis in our hospital from 2006 to 2013 were enrolled as subjects.Based on whether the PCT level was monitored or not,we divided patients into regular group and PCT group.For the regular group,we applied antibiotic treatment and determined the course of treatment based on clinical symptoms,laboratory test results,medical imaging results,and bacterial culture.For the PCT group,in addition to the above treatments,antibiotic treatment was applied when the PCT level was not lower than 0.25ng/ml and stopped when the PCT level was lower than 0.25 ng/ml.The distribution of bacterial infection sites,type of bacteria,type of antibiotics,average period of hospitalization,and course of antibiotic treatment were compared between the two groups.Results There were no significant differences in the distribution of bacterial infection sites,type of bacteria,type of antibiotics,and average period of hospitalization between the two groups （P〉0.05）.The course of antibiotic treatment for the PCT group was significantly shorter than that for the regular group （25.37±11.66 vs 20.58±7.53 d,P〈0.05）.Conclusion Under similar conditions of bacterial infection,antibiotic treatment of TCE-induced dermatitis based on the serum PCT level can significantly shorten the course of treatment and avoid the abuse of antibiotics.