监测血清降钙素原水平指导急性肾盂肾炎患者抗生素临床应用的研究

Study on procalcitonin level guidance for antibiotics clinical application of acute pyelonephritis

目的通过分析血清降钙素原（PCT）变化，指导抗生素在急性肾盂肾炎（APN）治疗中的应用。方法选取APN患者70例，随机分为两组，治疗组36例：根据PCT的变化决定是否使用抗生素；对照组34例：常规使用抗生素2周；比较两组治疗前后临床表现、PCT变化、尿培养结果、抗生素使用时间及治疗效果。结果两组PCT测定值的变化与临床表现基本相符，治疗后PCT恢复到低水平，两组尿培养结果、抗生素敏感及治疗效果比较差异均无统计学意义（P〉0．05），但治疗组抗生素使用时间为（9．38±1．03）天，对照组为（13．97±0．16）天，两组比较差异有统计学意义（P〈0．05）。结论APN患者动态监测血清PCT水平变化，可缩短抗生素治疗时间。

Objective To guide the application of antibiotics in the treatment of acute pyelone- phritis,through the detection of serum procalcitonin （PCT） levels. Methods 70 patients were randomly divided into two groups, the use of antibiotics or not in the observation group was on the base of the serum PCT level, the patients in the control group used antibiotics for 2 weeks. The serum PCT levels and clinical manifestation, the urine culture, antibiotic duration, clinical effect was compared before and after of the treatment. Results The serum PCT level, the clinical manifestations in the two groups were no obvious defference. After treatment, the serum PCT returned to low levels in the two groups. And the urine culture results,antibiotic sensitivity and the therapeutic effect was no difference, but compared to the control group, the time using antibiotics in the observation group two shorten by （4.62 ± 1.03 ）days（ P 〈 0.05 ）. Conclusion The serum PCT levels can be used for the application of antibiotics for acute pyelonephritis patients, and the time using antibiotic can be shorten.