血清降钙素原(PCT)检测对于老年心衰抗感染治疗的指导意义分析

Guiding Significance of Serum Calcitonin Original(PCT) in the Anti-infection Treatment for Senile Heart Failure

目的:探讨血清降钙素原(PCT)对于老年心衰患者抗感染治疗中的指导意义。方法:选取我院于2013年1月-2014年6月间收治的130例老年心衰患者,将其随机分为观察组以及对照组,每组65例,对照组根据患者的病情变化决定是否使用抗菌药物,而观察组根据PCT变化决定是否使用抗菌素治疗。比较2组患者的体温、PCT、WBC、CRP变化情况,治疗效果,住院情况以及抗菌素使用情况。结果:观察组在使用抗菌药物当日的PCT水平明显低于入院时,P<0.05,而体温、WBC、CRP水平比较无明显差异,使用抗菌药物3 d后,血清PCT水平相比于使用抗菌素当日明显下降,体温相比于入院时显著下降,P<0.05。观察组的二重感染率明显低于对照组,P<0.05,观察组的抗菌药物使用疗程、费用以及总住院费用均明显低于对照组,组间比较有明显差异,P<0.05。结论:PCT指标应用于老年心衰患者应用抗菌素的指导治疗,能够减少抗菌药物的使用量,降低住院费用,减少住院时间,减少二重感染的发生率。

Objective： To study the guiding significance of serum calcitonin original（PCT） using in the anti-infection treatment for senile heart failure. Methods： 130 cases of senile heart failure patients in our hospital form January 2013- June 2014 were selected and randomly divided into observation group and control group, 65 cases in each group. According to the patient＇s condition, the patients in control group were decided whether to use antimicrobial agents, while based on PCT changes, the patients in observation group were decided whether to use antibiotic treatment. The temperature, and the level of PCT, WBC and CRP were detected and the curative effect,hospitalization condition, and antibiotics usage were evaluated and compared between two groups. Results： The PCT level was significantly lower in the day of using antibacterial drugs than that of the day on admission in observation group, P〈0.05, and the temperature, the level of WBC and CRP had no significant difference. After using antibacterial drugs for 3 d, the serum PCT level was significantly lower than the day of using antibiotics, and temperature was significantly lower compared to the admission（P〈0.05）. Double infection rate of observation group was obviously lower than the control group, P〈0.05. The course of antimicrobial drug use, the cost and total cost of hospitalization were significantly lower in the observation group than that of the control group with statistical significance（P〈0.05）. Conclusions： PCT index using in the guidance of antimicrobial therapy for elderly patients with heart failure can reduce the usage of antibacterial agents, reduce hospitalization expenses, reduce the incidence of double infection.