血清降钙素原监测在老年心力衰竭患者抗感染治疗中的应用研究

Clinical value of PCT in guiding treatment of infection in elderly patients with heart failure

目的探讨降钙素原(PCT)监测指导老年心力衰竭患者抗感染治疗的临床应用效果。方法随机选择120例老年心力衰竭合并肺部感染患者,按自愿原则分为对照组(50例)与观察组(70例)。对照组根据症状及病情给予常规治疗。观察组根据血清PCT水平调整抗感染治疗方案。比较两组患者治疗有效率、治疗费用、住院时间等指标。结果观察组、对照组治疗有效率分别为78.57%、78.00%,比较差异无统计学意义(P>0.05)。观察组、治疗组治疗费用、住院时间、抗菌药物使用时间、抗菌药物费用比较差异有统计学意义(P<0.05)。观察组二重感染率、病死率低于对照组(P<0.05)。与治疗前相比,观察组与对照组治疗后血细胞沉降率、C反应蛋白(CRP)、白细胞计数、中性粒细胞比例均明显改善(P<0.05),观察组治疗后CRP水平低于对照组(P<0.05)。结论根据PCT水平指导老年心力衰竭患者抗感染治疗有利于缩短治疗时间、降低治疗成本、改善患者预后,值得临床推广应用。

Objective To investigate clinical value of procalcitonin（PCT）in guiding treatment of infection in elderly patients with heart failure.Methods A total of 120 cases of elderly patients with heart failure and infection were divided into control group（50cases）,receiving conventional anti-infection treatment,and observation group（70cases）,receiving adjusted anti-infection treatment based on serum PCT levels.Treatment efficiency,cost of treatment,hospitalization duration and other indicators were compared between the two groups.Results Effective rate of observation group was 78.57%,which was not significantly different with the 78.00% of control group（P〉0.05）.Cost of treatment,hospitalization duration,application time of antibiotics,antibacterial drug costs,superinfection and mortality were significantly different between the two groups（P〈0.05）.After treatment,levels of erythrocyte sedimentation rate,C-reaction protein,white blood cells and neutrophil in the two groups were significantly improved（P〈0.05）.After treatment,C-reaction protein level of observation group was lower than control group（P〈0.05）.ConclusionPCT based anti-infection treatment could help shorten the treatment time,reducing treatment costs and improving outcomes,and might be worthy of clinical application.