降钙素原在急诊感染患者中指导抗生素应用的价值研究

The guiding Value of Procalcitonin on the Used of Antibotics for the Emergency Patients with Infection

目的:探讨降钙素原(PCT)在急诊感染性疾病患者中,指导抗生素启动及停止治疗中的价值。方法:选择2014年4月1日至2015年3月31日在我院急诊科就诊并留观或住院治疗的急性感染患者253例,分为常规治疗组(75例)和PCT指导治疗组(178例)。常规治疗组给予经验性抗感染治疗;PCT治疗组在基础检查的基础上,就诊时即采血进行PCT检测,以后在抗生素治疗期间,在病程第3、5、7天重新检测PCT进行评估。对比两组患者第一天使用抗生素比例、抗生素总使用时间,总住院时间和病死率。结果:PCT指导治疗组第一天抗生素使用率较常规治疗组明显降低(85.96%vs 96.00%,P<0.05)。PCT指导治疗组中抗生素总使用时间较常规治疗组缩短[(7.93±3.13)天vs(6.48±3.58)天,P<0.05]。同时PCT指导治疗组患者平均总住院时间较常规治疗组相比明显缩短(P<0.05),两组间总病死率无明显差异(P>0.05)。结论:PCT可有效指导急诊感染患者抗生素启动及停止,具有良好的应用价值。

Objective:To explore the guiding value of procalcitonin(PCT)on the initiation and termination of the antibotics for the infectious patients in the emergency department.Methods:253 patients from April 1st,2014 to March 31st,2015 were divided into the regularly treatment group(75 cases)and PCT guided group(178 cases). The patients in regularly treatment group received the regularly antibotics plan.The PCT of the patients in PCT guided group were mea-sured when the got the hospital immediately and measured at the 3 rd,5 th and 7 th day during the antibotics treated peri-od to determine whether stop the antibotics or not. The ratio of initiation antibotics at the first day,the total time of anti-botic treatment,length of hospital stays and mortality were analyzed.Results:Compared with the regularly treatment group,the PCT guided group has a lower ratio of initiation antibotics at the first day(85.96% vs 96.00%,P<0.05). The duration of antibotics treatment in PCT guided group was shorter than that in the regularly treatment group((7.93±3.13)days vs(6.48±3.58)days,P<0.05)In addition,the length of hospital stays was shorter in the PCT guided group(P<0.05). There was no different in the mortality between the two groups(P>0.05).Conclusion:It could be beneficial to used PCT to guide the initiation and termination in the infectious disease.