血清降钙素原指导成人下呼吸道感染抗菌治疗73例

Serum Procalcitonin-guided Antibiotic Therapy of 73 Cases with Adult Lower Respiratory Tract Infection

目的利用血清降钙素原(PCT)水平指导抗菌药物使用,减少下呼吸道感染患者抗菌药物暴露,降低医疗费用。方法收集2015—2017年成人下呼吸道感染患者131例,随机分为试验组(73例)和对照组(58例)。对照组参照相关指南进行抗感染治疗,试验组同时参考PCT水平;以患者死亡、转入重症监护室(ICU)、发生并发症及30d内复发感染需要抗菌药物治疗为研究终点,比较两组患者抗菌药物疗程、金额及住院费用的差异性。结果两组患者死亡、转入ICU、发生并发症以及30d内复发感染需要抗菌药物治疗等指标均差异无统计学意义(P>0.05);试验组临床有效率为93.2%,较对照组高。试验组和对照组抗菌药物疗程分别为(6.14±2.19),(8.16±2.95)d,两组比较差异有统计学意义(P<0.05);试验组与对照组抗菌药物金额分别为(1219.92±868.80),(1977.82±1042.18)元,住院费用分别为(5621.57±1335.09),(7415.05±1553.47)元,两组比较均差异有统计学意义(P<0.05)。结论血清PCT水平指导成人下呼吸道感染抗菌治疗可在不增加安全风险的情况下减少抗菌药物暴露,降低住院费用,具有一定的临床价值。

Objective Use serum procalcitonin(PCT)levels to guide the use of antibiotics to reduce exposure time and reduce medical costs in patients with lower respiratory tract infections.Methods Collecting 131 cases of adult lower respiratory tract infection patients from 2015 to 2017.Patients were randomly divided into experimental group(73 cases)and control group(58 cases).The control group was treated with anti-infective treatment according to the relevant guidelines.The use of antibiotics in experimental group according to the PCT level.The study ended with patient death,transfer to ICU,complications,and recurrent infection within 30 days.The differences in the course and amount of antibacterial drugs and hospitalization costs between the two groups were compared.Results There were no significant differences between the two groups in terms of death,transfer to the ICU,complications,and relapse infection within 30 days(P<0.05).The clinical effective rate of the experimental group was 93.2%,which was higher than that of the control group.The course of antibiotics in the experimental group and the control group were(6.14±2.19)d and(8.16±2.95)d,respectively.The difference between the two groups was statistically significant(P<0.05).The amount of antibiotics in the experimental group and the control group were(1 219.92±868.80)yuan and(1 977.82±1 042.18)yuan,respectively;the hospitalization expenses were(5 621.57±1 335.09)yuan and(7 415.05±1 553.47)yuan,respectively.The difference between the two groups was statistically significant(P<0.05).Conclusion Serum PCT level can guide adult anti-infection of lower respiratory tract infection,which can reduce the exposure of antibiotics and reduce the cost of hospitalization without increasing the safety risk.It has certain clinical value.