降钙素原、C反应蛋白及肝素结合蛋白指导ICU脓毒症患者抗菌药物使用的临床效果

Clinical Effect of Procalcitonin,C-reactive Protein and Heparin Binding Protein Guiding Antibiotic Use in ICU Patients with Sepsis

目的:分析降钙素原(PCT)、C反应蛋白(CRP)、肝素结合蛋白(HBP)指导ICU脓毒症患者抗菌药物使用的临床效果.方法:选取2021年7月—2023年6月遵义市第一人民医院ICU收治的脓毒症患者300例作为研究对象,随机分为PCT组、CRP组、HBP组、常规组,各75例.所有入组患者在确诊到停药期间分别进行血清PCT、CRP、HBP监测,其中PCT组、CRP组、HBP组均监测至相应临界值以下再停止用药,常规组根据经验及患者症状停止用药.比较四组病情转归、恢复情况、并发症.结果:HBP组痊愈率高于PCT组、CRP组、常规组,HBP组休克率、复发率低于常规组,差异有统计学意义(P<0.05);HBP组ICU住院时间、总住院时间短于PCT组、CRP组、常规组,治疗费用少于PCT组、CRP组、常规组,差异有统计学意义(P<0.05);HBP组并发症发生率低于CRP组、常规组,差异有统计学意义(P<0.05).结论:PCT、CRP、HBP均可对ICU脓毒症患者的抗菌药物使用进行指导,但采用HBP指导可促进抗菌药物治疗后病情转归,降低复发率与休克率,且可减少并发症的发生.

Objective:To analyze the clinical effects of procalcitonin(PCT),C-reactive protein(CRP)and heparin binding protein(HBP)in guiding antibiotic use in ICU patients with sepsis.Methods:A total of three hundred patients with sepsis admitted to ICU of Zunyi First People's Hospital from July 2021 to June 2023 were selected as the study objects,and randomly divided into PCT group,CRP group,HBP group and routine group,with seventy-five patients in each group.Serum PCT,CRP and HBP were monitored in all enrolled patients from diagnosis to drug withdrawal.Among them,PCT group,CRP group and HBP group were all monitored below the corresponding critical value before stopping medication,while routine group stopped medication according to experience and symptoms of patients.The prognosis,recovery and complications of the four groups were compared.Results:The recovery rate of HBP group was higher than that of PCT group,CRP group and routine group,and the shock rate and recurrence rate of HBP group were lower than that of routine group,the difference was statistically significant(P<0.05);the length of ICU stay and total length of hospital stay in HBP group were shorter than those in PCT group,CRP group and routine group,and the treatment cost was lower than those in PCT group,CRP group and routine group,the difference was statistically significant(P<0.05);the complication rate of HBP group was lower than that of CRP group and routine group,and the difference was statistically significant(P<0.05).Conclusion:PCT,CRP and HBP can all guide the use of antibiotics in ICU sepsis patients,but HBP guidance can promote the prognosis after antibiotic treatment,reduce the recurrence rate and shock rate,and reduce the occurrence of complications.