动态监测降钙素原对非重症社区获得性肺炎的临床治疗价值研究

Study on The Clinical Value Treatment of Procalciton in Non Severe Community Acquired Pneumonia

目的 :观察血清降钙素原(pCT)在社区获得性肺炎患者诊治过程中的变化,根据血清pCT水平指导抗生素选择,分析pCT在非重症社区获得性肺炎治疗过程中的临床价值。方法：选取2013年12月~2014年12月来我院门诊和病房就诊的非重症社区获得性肺炎患者120例,随机分为观察组和对照组,观察组按照pCT水平指导是否用抗生素,经过抗生素治疗后的3~5天再评估pCT水平,当pCT值下降超过90%停用抗生素;对照组根据用药指导判断抗生素选择,治疗过程中测定患者的Crp、WBC及体温等,将患者临床治疗效果按照治愈、显效、好转或无效进行评估。结果 :两组肺炎患者治疗有效率分别为91.7%和93.3%,治疗的有效率不存在明显差异,但是根据pCT进行选药的观察组,抗生素使用天数和治疗费用要明显低于对照组,差异有显著性。结论 :监测血清pCT在非重症社区获得性肺炎的临床治疗中有指导价值,可降低抗生素的使用天数,减少患者医疗负担,对临床用药有参考意义。

Objective To observe the serum calcitonin original (PCT) in the diagnosis and treatment of patients with com-munity-acquired pneumonia in the process of change, guide the antibiotic selection based on the characteristics of changes of PCT, the clinical value in the process of analysis of PCT in pneumonia. Selection Methods The patients with severe commu-nity-acquired pneumonia, were randomly divided into observation group and control group, the observation group, in accord-ance with the PCT level guidance with antibiotics, control group according to the guidelines for judging the antibiotic selection, treatment in the process of determination of CRP, WBC and body temperature, etc, in patients with the clinical therapeutic ef-fects were observed. Results Two groups of patients with pneumonia treatment effectiveness, there was no significant difference before and after treatment of CRP, WBC and temperature decreased significantly, according to the PCT choose medicine group, the antibiotic utilization rate and medical costs significantly lower than the control group, two groups of patients in hospital time no statistical difference. Conclusion monitoring the PCT in the course of clinical treatment of severe community-acquired pneumonia has a guiding value, can reduce the antibiotic usage, reduce the patients’medical costs.