降钙素原联合C反应蛋白检测在神经内科住院患者中的临床研究

Clinical research of procalcitonin combined with C-reactive protein detection for hospitalized patients in department of neurology

目的研究降钙素原(PCT)联合C反应蛋白(CRP)对神经内科住院患者抗感染治疗的参考价值,为治疗用药提供依据。方法 100例神经内科住院患者,随机分为实验组和对照组,各50例。实验组患者进行PCT联合全血CRP常规检测,参照检测结果对患者的治疗用药进行实时调整;对照组患者按照神经内科住院患者诊疗规范进行治疗。比较实验组与对照组患者抗生素使用频度(DDDs)、抗生素使用强度(AUD)及住院时间;比较参照PCT与CRP联合检测结果 (实验组)与单纯参照PCT结果 (单纯组)确定抗生素使用情况患者的抗生素使用指标及住院时间。结果实验组患者DDDs为(3830±1430)、AUD为(38.4±7.8),明显低于对照组的(8850±1680)、(89.5±9.4),差异有统计学意义(P<0.05);实验组患者住院时间为(7.0±1.5)d,短于对照组的(13.0±2.5)d,差异有统计学意义(P<0.05)。实验组与单纯组患者DDDs、AUD、住院时间比较差异无统计学意义(P>0.05)。结论依据实验结果决定患者用药治疗,能够有效降低抗生素使用强度及使用频度,单纯PCT检测结果能够满足临床需求,避免了过度检测。

Objective To research reference value by procalcitonin （PCT） combined with C-reactive protein （CRP） for anti-infective therapy in hospitalized patients in department of neurology, and to provide reference for treatment medication. Methods A total of 100 hospitalized patients in department of neurology were randomly divided into experimental group and control group, with 50 cases in each group. The experimental group received PCT combined with CRP routine detection, along with real time adjustment of treatment medication in accordance with detection outcome. The control group received treatment by department of neurology standard. Comparison was made on antibiotics defined daily dose system （DDDs）, antibiotics use density （AUD） and hospital stay time between the experimental group and the control group. Antibiotics using index and hospital stay time were compared between patients receiving antibiotics based on their PCT combined with CRP detection outcome （experimental gruop） and single PCT detection outcome （single group）. Results The experimental group had obviously lower DDDs as （3830 ± 1430） and AUD as （38.4 ± 7.8） than （8850 ± 1680） and （89.5 ± 9.4） in the control group, and the difference had statistical significance （P〈0.05）. The experimental group had shorter hospital stay time as （7.0 ± 1.5） d than （13.0 ±2.5） d in the control group, and the difference had statistical significance （P〈0.05）. There was no statistically significant difference of DDDs, AUD, and hospital stay time between the experimental group and the single group （P〉0.05）. Conclusion Medication treatment determined on the basis of experimental outcomes can effectively lower use density and frequency. Single PCT detection can provide satisfactory clinical outcome, and it can avoid excessive detection.