检测降钙素原在非重症成人获得性肺炎中的临床意义

Clinical significance of detecting procalcitonin for mild community-acquired pneumonia in adults

目的:探讨用降钙素原检测来评估口服抗生素治疗非重症成人社区获得性肺炎的临床价值。方法:124例非重症社区获得性肺炎病人,随机分成口服治疗组(A组)和静滴治疗组(B组),每组62人。对病人在用药前、用药后第3、5、7、9天分别检测血浆降钙素原(procalcitonin,PCT)、血常规、C-反应蛋白(CRP),并进行分析。结果:A组PCT的下降趋势比B组更显著(P<0.05),CRP和白细胞(WBC)有类似变化,但不如PCT明显。治疗3、5、7、9d后PCT的灵敏度和特异性在两组间比较均无统计学意义(P>0.05);在疗程方面,A组为(7.6±1.4)d、B组为(9.0±2.3)d,差异有统计学意义(P<0.05);而治疗有效率无统计学差异(P>0.05)。结论:血浆PCT检测能指导非重症社区获得性肺炎的抗生素治疗,缩短抗生素疗程,大幅度减少抗生素的使用,标准的口服抗生素治疗非重症社区获得性肺炎的效果优于静脉治疗,值得临床推广使用。

Objective. To explore the clinical value of detecting procalcitonin （PCT） level in oral antibiotic treatment of mild community-acquired pneumonia （MCAP） in adults. Methods： Totally,124 patients with MCAP （male 75, female 49, age 19-75）, were randomly divided into two groups： the oral treatment group （group A） and the intravenous treatment group （group B）, each consisting of 62 patients. The levels of plasma procalcitonin（PCT）, blood routine, C-reactive protein （CRP） were detected before and after 3, 5, 7, 9 days of treatment respectively, and then the obtained data were analyzed, Results The descending trend of PCT in group A was more significant than that in group B （P〈0.05）. There were similar changes in CRP and white blood cells （WBC）, and those changes were not significant as compared with PCT, No statistical significance could be noted in sensitivity and specificity of PCT after 3, 5, 7 and 9 days of treatment, when comparisons were made between the 2 groups （P〉0. 05）, The treatment course of group A was （7.6±1. 4） d and that of group B was （9. 0±2.8） d. Statistical significance could be seen, when comparisons were made between the 2 groups （P〈0.05）. Statistical significance could neither be seen in treatment efficacy, when comparisons were made between the 2 groups （P〉0.05）, Conclulon： Plasma PCT detection could give direction to antibacterial treatment of mild community-acquired pneumonia, shorten treatment course and substantially reduce antibiotic use in the treatment of MCAP. Standard oral antibiotic therapy for the treatment of MCAP was superior to intravenous therapy. For this reason, it was worth further clinical extension.