降钙素原对儿童社区获得性肺炎抗菌药物选择及疗效的影响

Serum Procalcitonin for the Choice of Antibiotic and Therapy Effect in Children with Community Acquired Pneumonia

目的:探讨血清降钙素原(PCT)对指导儿童社区获得性肺炎(CAP)抗菌药物选择以及疗效的影响。方法:采用前瞻性研究方法,收集2014年5月至2016年5月我院儿科收治的172例儿童CAP患儿的临床资料,随机分为血清PCT指导抗菌药物选择组(观察组)和临床指导标准选择组(对照组)各86例,比较两组患儿抗菌药物使用率、抗菌药物使用时间、疗效等指标。结果:观察组患儿抗菌药物使用率、抗菌药物使用时间以及两种抗菌药物联用率均低于对照组(P均<0.05)。两组患儿抗菌药物不良反应发生率、退热时间、住院时间以及复发率比较差异均无统计学意义(P均>0.05)。结论:应用血清PCT指导CAP患儿抗菌药物的使用能显著降低抗菌药物使用率、缩短使用时间且不影响临床疗效,有助于合理使用抗菌药物。

Objective：To explore the value of serum procalcitonin（PCT） for the guidance of antibiotic therapy and effect of therapy in children with community acquired pneumonia（CAP）.Methods：A prospective randomized controlled study was conducted in 172 children with CAP who visited our hospital from May 2014 to May 2016.The participants were randomly assigned into the observation group（n=86） in which the antibiotic therapy was guided by serum PCT level and the control group in which the standard therapy was given according to clinical guidance（n=86）.Afterwards,antibiotic prescription rate,duration of antibiotic treatment,and therapeutic effect were compared between the groups.Results：The antibiotic prescription rate,mean duration of antibiotic treatment and combined antibiotic prescription rate were lower in the observation group than those in the control group（P〈0.05）.There were no differences in the rate of adverse reactions from antibiotic therapy,the length of hospital stay,defervesce time and recurrence rate between two groups（P〉0.05）.Conclusion：Serum PCT-based guidelines on antibiotic use could reduce the rate of antibiotic utilization ratio,shorten the duration of antibiotic therapy without compromising efficacy in children with community acquired pneumonia,which contribute to the rational use of antibiotics.