中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2008年
9期
974-977
,共4页
龙威%邓星奇%谢娟%唐建国%高育瑶%陆刚%张奕翠%陆伟%张羽%施劲东%何伟%黄建芳
龍威%鄧星奇%謝娟%唐建國%高育瑤%陸剛%張奕翠%陸偉%張羽%施勁東%何偉%黃建芳
룡위%산성기%사연%당건국%고육요%륙강%장혁취%륙위%장우%시경동%하위%황건방
降钙素原%肺疾病,慢性阻塞性
降鈣素原%肺疾病,慢性阻塞性
강개소원%폐질병,만성조새성
Procalcitonin(PCT)%Pulmonary diseases,chronic obstructive
目的 研究血清降钙素原(PCT)检测在慢性阻塞性肺疾病急性加重(AECOPD)患者治疗时抗生索使用中的临床意义.方法 选取2004年5月至2006年12月间收治入院的AECOPD患者235例,随机分配为常规治疗组117例(A组)和PCT指导治疗组118例(B组),入院后即用荧光增强发射法检测血清PCT水平.在相同常规治疗基础上,A组由经治医师按照抗生素使用指南决定抗生素治疗方案,B组按照血清PCT水平决定是否使用抗生素,在血清PCT≥0.25 mg/ml时,进行抗生素治疗,PCT＜0.25 ng/ml时,不予抗生素治疗.观察两组患者的住院时间、临床有效率、住院费用及抗生素费用、抗生素使用率、住院病死率、1年随访期间AECOPD发生率及住院率.采用:检验、Mann-Whitney U检验及X2检验进行统计学分析.结果 两组患者在临床有效率、住院病死率、住院时间及1年随访期间AECOPD发生率及住院率方面差异无统计学意义(P分别为0.635、0.768、0.884、0.747和0.727),PCT指导治疗组的抗生素费用、住院费用及抗生素使用率均低于常规治疗组(P分别为0.029,0.036和0.014).结论 AECOPD患者入院之初可以进行PCT水平检测以指导抗生素使用,能够降低抗生素使用率,减少用于抗生素使用的费用和总的住院费用.
目的 研究血清降鈣素原(PCT)檢測在慢性阻塞性肺疾病急性加重(AECOPD)患者治療時抗生索使用中的臨床意義.方法 選取2004年5月至2006年12月間收治入院的AECOPD患者235例,隨機分配為常規治療組117例(A組)和PCT指導治療組118例(B組),入院後即用熒光增彊髮射法檢測血清PCT水平.在相同常規治療基礎上,A組由經治醫師按照抗生素使用指南決定抗生素治療方案,B組按照血清PCT水平決定是否使用抗生素,在血清PCT≥0.25 mg/ml時,進行抗生素治療,PCT＜0.25 ng/ml時,不予抗生素治療.觀察兩組患者的住院時間、臨床有效率、住院費用及抗生素費用、抗生素使用率、住院病死率、1年隨訪期間AECOPD髮生率及住院率.採用:檢驗、Mann-Whitney U檢驗及X2檢驗進行統計學分析.結果 兩組患者在臨床有效率、住院病死率、住院時間及1年隨訪期間AECOPD髮生率及住院率方麵差異無統計學意義(P分彆為0.635、0.768、0.884、0.747和0.727),PCT指導治療組的抗生素費用、住院費用及抗生素使用率均低于常規治療組(P分彆為0.029,0.036和0.014).結論 AECOPD患者入院之初可以進行PCT水平檢測以指導抗生素使用,能夠降低抗生素使用率,減少用于抗生素使用的費用和總的住院費用.
목적 연구혈청강개소원(PCT)검측재만성조새성폐질병급성가중(AECOPD)환자치료시항생색사용중적림상의의.방법 선취2004년5월지2006년12월간수치입원적AECOPD환자235례,수궤분배위상규치료조117례(A조)화PCT지도치료조118례(B조),입원후즉용형광증강발사법검측혈청PCT수평.재상동상규치료기출상,A조유경치의사안조항생소사용지남결정항생소치료방안,B조안조혈청PCT수평결정시부사용항생소,재혈청PCT≥0.25 mg/ml시,진행항생소치료,PCT＜0.25 ng/ml시,불여항생소치료.관찰량조환자적주원시간、림상유효솔、주원비용급항생소비용、항생소사용솔、주원병사솔、1년수방기간AECOPD발생솔급주원솔.채용:검험、Mann-Whitney U검험급X2검험진행통계학분석.결과 량조환자재림상유효솔、주원병사솔、주원시간급1년수방기간AECOPD발생솔급주원솔방면차이무통계학의의(P분별위0.635、0.768、0.884、0.747화0.727),PCT지도치료조적항생소비용、주원비용급항생소사용솔균저우상규치료조(P분별위0.029,0.036화0.014).결론 AECOPD환자입원지초가이진행PCT수평검측이지도항생소사용,능구강저항생소사용솔,감소용우항생소사용적비용화총적주원비용.
Objective To evaluate the value of serum procalcitonin(PCT)on antibiotics use in treatment of acute exacerbations of chronic obstructive pulmonary disease( AECOPD). Method From May 2004 to December 2006, a total of 235 patients requiring hospitalization for AECOPD were randomly assigned into two groups: standard therapy group(group A, n = 117)and PCT-guided group(group B, n = 118) .PCT levels of all patients were measured after hospital admission by an amplified cryptate emission technology assay. On the base of similarly normal treatment, group A received antibiotics according to the attending physicians,and group B were treated with antibiotics according to serum PCT levels:antibiotic treatment was applied with PCT level ≥0.25 ng/ml and was discouraged with PCT level ＜0.25 ng/ml. Length of hospitalization,clinical efficacy,costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality,rate of exacerbation and rehospitalization within 1 year were observed. Analyses were performed by t test, Mann-Whitney U test or χ2 test. Results Clinical efficacy, hospital mortality, length of hospitalization, rate of exacerbation and rehospitalization within 1 year were similar in two groups (P =0.635,0.768,0.884,0.747,0.727) ;costs of antibiotics and hospitalization,rate of antibiotics use of PCT-guided group were lower than that of standard therapy group( P = 0.029,0.036,0.014). Conclusions PCT could be used in treatment of AECOPD for antibiotic use after hospital admission,which may reduce antibiotic use and lower costs of antibiotic and hospitalization.
