PCTc在老年心力衰竭患者抗感染治疗中的指导价值及应用

Guiding Value and Application of PCTc in Anti-infective Therapy in Elderly Patients with Heart Failure

目的探讨血清降钙素原清除率(PCTc)在老年心力衰竭患者抗感染治疗中的指导价值及应用。方法选取我院2018年1月~2019年5月收治的老年心力衰竭患者80例,采用随机数字分为对照组和试验组,各40例。对照组给予常规治疗,观察组在常规治疗的基础上根据PCTc测量水平调整抗菌药物种类及用量,比较两组治疗前后白细胞计数、血沉(ESR)、C-反应蛋白(CRP)以及中性粒细胞比例、住院时间、抗菌药物费用、抗菌药物使用时间、二重感染率、病死率以及治疗费用。结果观察组住院时间、抗菌药物费用、抗菌药物使用时间、二重感染率、病死率以及治疗费用低于对照组,差异有统计学意义(P<0.05)。治疗后两组白细胞计数、ESR、CRP水平和中性粒细胞比例均低于治疗前,且观察组CRP水平低于对照组,差异有统计学意义(P<0.05)。结论在老年心力衰竭患者抗感染治疗进程中监测PCTc对指导医师调整抗菌药物种类及用量具有重大意义,可有效改善患者炎症因子水平、缩短患者住院时间,减少二重感染率和病死率,节省医疗费用,提升生活质量。

Objective To explore the guiding value and application of serum procalcitonin clearance rate(PCTc)in anti-infective treatment of elderly patients with heart failure.Methods A total of 80 elderly patients with heart failure treated in our hospital from January 2018 to May 2019 were selected and randomly divided into a control group and a test group,each with 40 patients.The control group was given conventional treatment,and the observation group adjusted the type and dosage of antibacterial drugs according to the PCTc measurement level on the basis of conventional treatment,and compared the white blood cell count,erythrocyte sedimentation(ESR),C-reactive protein(CRP),and neutrophils before and after treatment.Proportion,length of hospital stay,cost of antimicrobials,duration of antimicrobial use,double infection rate,mortality and treatment costs.Results The observation group's length of hospital stay,cost of antibacterials,time of use of antibacterials,double infection rate,mortality and treatment costs were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the white blood cell counts,ESR,CRP levels,and neutrophil ratios of the two groups were lower than before treatment,and the CRP level of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion Monitoring PCTc in the course of anti-infective treatment of elderly patients with heart failure is of great significance for guiding physicians to adjust the type and dosage of antibacterial drugs,which can effectively improve the level of inflammatory factors,shorten the length of hospitalization,reduce the rate of double infection and mortality,and save medical cost and improve quality of life.