降钙素原指导慢性阻塞性肺疾病急性加重期患者的抗菌药物使用

Procalcitonin in guiding antibiotic use in patients with AECOPD

目的探讨降钙素原在指导慢性阻塞性肺疾病急性加重期(AECOPD)患者抗菌药物使用方面的价值。方法选取2014年3月至2015年9月航天中心医院呼吸科诊治的AECOPD患者184例,采用随机数字表法分为对照组和观察组两组,各92例。对照组患者根据临床经验实施抗菌药物治疗,观察组患者根据血清降钙素原浓度实施抗菌药物治疗。结果观察组患者治疗后降钙素原水平较治疗前显著降低(P<0.05)。观察组患者治疗后降钙素原、半年内再次急性加重发生率、半年内再住院率低于对照组(P<0.05)。观察组患者抗菌药物使用时间、抗菌药物费用、住院时间、住院费用少于对照组(P<0.05)。两组患者治疗总有效率、住院病死率比较,差异无统计学意义(P>0.05)。结论 AECOPD患者血清降钙素原显著升高,参考降钙素原水平有助于优化抗菌药物的使用。

Objective To investigate the value of procalcitonin in guiding the antibiotic use in acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods A total of 184 patients with AECOPD in our hospital from March 2014 to September 2015 were selected and divide into two groups by the random number table method.Ninety-two cases in the control group received the antibiotic therapy according to clinical experience.Ninety-two cases in the observation group was implemented the antibiotic therapy according to serum procalcitonin level.Results Compared with before treatment,the procalcitonin level after treatment in the observation group was decreased significantly（P〈0.05）.The procalcitonin level after treatment,occurrence rate of acute exacerbation within six months and re-hospitalization rate within six months in the observation group were lower than those in the control group（P〈0.05）.The antibiotic use time,antibiotic expenses,hospitalization time and hospitalization cost in the observation group were less than those in the control group（P〈0.05）.The total effective rate and hospitalization mortality rate had no statistical difference between the two groups（P〉0.05）.Conclusion Serum procalcitonin is significantly increased in the patients with AECOPD.Procalcitonin can be used for the optimized use of antibiotics.