CAJ | 학술논문

目的探讨血清降钙素原(PCT)监测在门诊接受治疗的社区获得性肺炎(CAP)患者的抗生素使用中的临床意义.方法选2006年11月-2008年2月符合CAP诊断标准的门诊接受治疗的CAP患者127例,随机分为PCT监测组(63例)和常规治疗组(64例),人选患者监测血清PCT水平.在相旧常规治疗的基础上,常规治疗组由经治医师按照我国CAP治疗指南决定抗生素治疗方案;PCT监测组按照血清PCT水平决定是否使用抗生素,在血清PCT≥0.25μg/L时进行抗生素治疗,PCT<0.25μg/L时不予抗生素治疗,之后复诊亦按照此标准决定是否继续使用抗生素.观察2组患者的临床治疗有效率、抗生素使用率、抗生索疗程及抗生素费用.结果 PCT监测组临床治疗有效率(92.1%)与常规治疗组(87.5%)相比差异无统计学意义(P>0.05),PCT监测组的抗生素使用率、抗生素疗程及抗生素费用均低于常规治疗组(P值均小于0.05),2组患者的预后无明显差异.结论门诊接受治疗的CAP患者可以依据PCT水平指导抗生素应用,能够减少抗生素用量,缩短抗生素疗程,降低抗生素费用.
목적 탐토혈청강개소원(PCT)감측재문진접수치료적사구획득성폐염(CAP)환자적항생소사용중적림상의의.방법 선2006년11월-2008년2월부합CAP진단표준적문진접수치료적CAP환자127례,수궤분위PCT감측조(63례)화상규치료조(64례),인선환자감측혈청PCT수평.재상구상규치료적기출상,상규치료조유경치의사안조아국CAP치료지남결정항생소치료방안;PCT감측조안조혈청PCT수평결정시부사용항생소,재혈청PCT≥0.25μg/L시진행항생소치료,PCT<0.25μg/L시불여항생소치료,지후복진역안조차표준결정시부계속사용항생소.관찰2조환자적림상치료유효솔、항생소사용솔、항생색료정급항생소비용.결과 PCT감측조림상치료유효솔(92.1%)여상규치료조(87.5%)상비차이무통계학의의(P>0.05),PCT감측조적항생소사용솔、항생소료정급항생소비용균저우상규치료조(P치균소우0.05),2조환자적예후무명현차이.결론 문진접수치료적CAP환자가이의거PCT수평지도항생소응용,능구감소항생소용량,축단항생소료정,강저항생소비용.
Objective To evaluate the value of serum procalcitonin (PCT)on antibiotic use in treatment of community acquired pneumonia (CAP) in outpatient. Methods From November 2006 to February 2008, a total of 127 patients with CAP in outpatient were randomly assigned into two groups:PCT group(n=63)and control group(n =64). PCT levels of all patients were measured after study admission. On the base of similarly normal treatment, the control group received antibiotics according to the attending physicians and the PCT group were treated with antibiotics according to serum PCT levels: antibiotic treatment was applied with PCT level ≥ 0. 25 μg/L and was discouraged with PCT level < 0.25 μg/L. Clinical efficacy, rate of antibiotics use, duration courses and costs of antibiotics were observed. Results Clinical efficacy of the PCT group was similar with the control group (92.1% vs 87.5%, P >0.05) ;rate and costs of antibiotics use was lower, antibiotic duration of the PCT group was shorter than that ofthecontroigroup(P<0.05,P<0.001,P<0.001).Conclusion PCT could be used in treatment of CAP for antibiotic use in outpatient, which may reduce antibiotic use, shorten antibiotic duration and lower costs of antibiotic.