测定血清降钙素原浓度指导抗生素治疗慢性阻塞性肺疾病急性加重期疗效分析

The investigation of the guiding significance of determination of serum procalcitonin concentrations on acute exacerbation of chronic obstructive pulmonary disease with antibiotic therapy

目的:探讨通过测定血清中降钙素原(PCT)水平,指导临床抗生素治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效。方法:收治慢性阻塞性肺疾病急性加重期患者240例,随机分为PCT组和常规组,各120例,所有患者在常规治疗的基础上,常规组按照抗生素使用指南进行治疗,PCT组根据血清中降钙素原浓度指导抗生素治疗。结果:两组患者住院费用、抗生素使用率、抗生素应用天数和真菌感染率相比差异均具有统计学意义(P<0.05)。两组患者治疗后临床有效率、30 d病死率、ACT评分以及重返率差异均无统计学意义(P>0.05)。结论:通过测定血清PCT浓度指导AECOPD治疗能够降低患者住院治疗的花费,降低抗生素的使用率及减少使用天数,降低真菌感染率,有助于减轻患者的经济负担,防止耐药性的产生。

Objective:To investigate the guiding significance of determination of serum procalcitonin(PCT) concentrations on acute exacerbation of chronic obstructive pulmonary disease with antibiotic therapy.Methods:240 patients with chronic obstructive pulmonary disease in acute exacerbation period were selected.They were randomly divided into the PCT group and the routine group with 120 cases in each.All the patients were given the conventional treatment in both of the group,and patients in the routine group were given antibiotics treatment according to the guidelines,while in the PCT group,patients were given antibiotics treatment guided by the serum procalcitonin concentration.Results:The differences in the cost of hospitalization,the antibiotic use rate,the days of antibiotic application and the fungal infection rate of the patients in two groups were statistically significant(P<0.05).However,the clinical efficiency,30 d mortality rate,ACT score and the readmission rate of patients had no significant differences between the two groups after treatment(P>0.05).Conclusion:Determination of serum PCT concentration in the guidance of AECOPD treatment can reduce the cost of hospitalization and the rate of antibiotics use,in addations,it also can reduce the days of antibiotics application and the rate of fungal infection,so it can decrease economic burden of patients and prevent drug resistance significantly.