降钙素原在急性胰腺炎患者中的诊疗价值

Diagnostic and therapeutic value of procalcitonin in patients with acute pancreatitis

目的研究血清降钙素原(PCT)在急性胰腺炎患者治疗过程中的意义。方法收集我院收治的45例急性胰腺炎患者,随机分成对照组和试验组。对照组开始治疗时即给予抗生素预防性或病因治疗,直至感染征象消失3 d后停用;试验组在血清PCT> 0. 5μg·L^(-1)时开始使用抗生素,隔日监测试验组患者PCT。比较2组患者的抗生素治疗时间、患者住院天数及住院费用。结果试验组第5,7,9天血清PCT水平分别为(1. 37±0. 64),(1. 24±0. 55),(0. 64±0. 32)μg·L^(-1),显著低于第1,3天的(2. 04±0. 87),(1. 92±0. 75)μg·L^(-1),差异有统计学意义(P <0. 05);第9天血清PCT水平显著低于第5,7天,差异有统计学意义(P <0. 05)。试验组的抗生素使用时间、住院天数和住院费用分别为(8. 32±1. 46) d,(9. 02±1. 15) d和(8. 20±0. 60)千元;对照组分别为(10. 86±1. 21) d,(12. 04±1. 69) d,(9. 20±1. 30)千元,差异均有统计学意义(均P <0. 05)。结论急性胰腺炎患者检测血清PCT在病情判断、预后评估及合理使用抗生素、缩短疗程等方面有着重要价值。

Objective To study the role of serum procalcitonin( PCT)in the treatment of patients with acute pancreatitis.Methods Forty-five patients with acute pancreatitis admitted to our hospital were randomly divided into control group and treatment group.Antibiotic prophylactic or etiological treatment was given to control group until the signs of infection disappeared for 3 d.The treatment group started antibiotics at serum PCT > 0.5 μg·L^-1,and the PCT was monitored every other day.The antibiotic treatment time,the length of hospital stay,and the hospitalization cost of the two groups were compared.Results The serum PCT levels in treatment group on 5,7 and 9 d were( 1.37±0.64),( 1.24±0.55),( 0.64±0.32)μg·L^-1,significantly lower than those in 1,3 d,which were( 2.04±0.87),( 1.92±0.75)μg·L-1( P < 0.05);the serum PCT level on day 9 was significantly lower than day 5 and day 7,the difference was statistically significant( P < 0.05).The antibiotic use time,hospital stay and hospitalization expenses of treatment group were( 8.32±1.46) d,( 9.02±1.15) and( 8.20±0.60)thousand yuan,all had significant difference with those in control group,which were( 10.86±1.21) d,( 12.04±1.69) d,( 9.20±1.30) thousand yuan( all P < 0.05).Conclusion The detection of serum PCT in patients with acute pancreatitis has important value in disease judgment,prognosis evaluation,rational use of antibiotics,and shortening of treatment.