血清降钙素原水平对重症加强护理病房重症合并感染患者的意义分析

Significance of serum procalcitonin level in critically ill patients with severe infection in intensive care unit

目的观察血清降钙素原(PCT)对重症加强护理病房(ICU)重症合并感染患者的临床意义。方法选取2017年3~9月在我院ICU住院病情较重患者140例,所有患者分成A、B两组,A组合并感染的患者70例,B组无感染的患者70例,观察A、B两组患者C反应蛋白(CRP)、PCT水平对重症感染的诊断价值。将A组患者随机分成两组,观察组35例患者根据PCT水平进行抗生素治疗,对照组35例患者按照临床指南进行抗生素治疗,观察两组患者经抗感染治疗后CRP水平及抗生素使用时间。结果(1) A、B组患者CRP进行比较差异有统计学意义(P <0.05),A组CRP诊断重症感染的阳性率达95.714%。A、B组患者PCT进行比较差异有统计学意义(P <0.05),B组PCT诊断重症感染的阳性率达97.143%。A组患者的CRP及PCT进行比较差异无统计学意义(P> 0.05)。(2)观察组治疗前后及对照组治疗前后CRP比较有差异,治疗后CRP均降低(P <0.05);观察组和对照组治疗前CRP比较差异无统计学意义(P> 0.05),治疗后比较有差异,观察组CRP更低(P <0.05);观察组及对照组抗生素使用时间比较有差异,观察组抗生素使用时间更短(P <0.05)。结论 PCT对ICU重症感染的诊断具有参考价值,PCT水平可以用于指导重症感染患者抗生素用量的调整,缩短抗生素使用时间。

Objective To observe the clinical significance of PCT in patients with severe infection in ICU.Methods One hundred and forty patients with severe illness from March 2017 to September 2017 in ICU of our hospital were selected. All patients were divided into A and B groups, group A had 70 patients with severe infection,group B had 70 severe cases without infection. The diagnostic value of CRP, PCT in patients of group A and B for severe infection were observed. Patients in group A were randomly divided into two groups, the observation group with35 patients were treated with antibiotics according to the level of PCT and the control group with 35 patients were given conventional anti infective treatment, then the CRP, PCT and antibiotic use time of patients in 2 groups after anti infective therapy were observed. Results(1)There were differences in CRP between group A and group B(P< 0.05), the positive rate of CRP in diagnosing severe infection in group A was 95.714%. There were differences in PCT between group A and group B(P < 0.05), the positive rate of PCT in diagnosing severe infection in group B was97.143%. There was no difference in CRP and PCT in group A(P > 0.05).(2)There were differences in CRP before and after treatment in the observation group, and there were differences in CRP before and after treatment in the control group, after treatment CRP was all decreased(P < 0.05). Before treatment, there were no difference in CRP between the observation group and the control group(P > 0.05). There were difference in CRP between the observation group and the control group, the CRP of the observation group was lower(P < 0.05). There were differences in antibiotic usage time between the observation group and the control group, the antibiotic usage time of the observation group was shorter(P < 0.05). Conclusion PCT is valuable for the diagnosis of severe ICU infection. At the same time, the level of PCT can be used to guide the adjustment of antibiotic dosage in patients with severe infection, and shorten antibiotic usage time.