CAJ | 학술논문

目的：探讨降钙素原(PCT)对慢性阻塞性肺疾病急性加重期(AECOPD)抗生素使用的指导意义。方法：选取2013年1-12月笔者所在医院收治的AECOPD患者248例，采用随机数字表法将其分为PCT组(132例)和常规组(116例)，常规组抗生素的使用由医师根据指南决定，而PCT组则根据患者PCT的水平来决定抗生素的使用。比较两组患者痰培养结果、抗生素的使用情况及临床治疗结果。结果：两组病原菌分布比较差异无统计学意义(P>0.05)。常规组的限制性或特殊使用级别的抗生素较多，常规组使用β内酰胺酶抑制剂或青霉素类(含酶抑制剂)明显高于PCT组，差异有统计学意义(P<0.05)；且PCT组患者的住院费用、抗生素费用以及抗生素的使用率均低于常规组，差异有统计学意义(P<0.05)。两组患者的住院时间、住ICU例数、临床好转率、住院病死率比较差异无统计学意义(P>0.05)。结论：PCT能够指导AECOPD抗生素的使用，能够减少抗生素的使用率，降低住院费用以及抗生素费用，不影响患者的预后。
목적：탐토강개소원(PCT)대만성조새성폐질병급성가중기(AECOPD)항생소사용적지도의의。방법：선취2013년1-12월필자소재의원수치적AECOPD환자248례，채용수궤수자표법장기분위PCT조(132례)화상규조(116례)，상규조항생소적사용유의사근거지남결정，이PCT조칙근거환자PCT적수평래결정항생소적사용。비교량조환자담배양결과、항생소적사용정황급림상치료결과。결과：량조병원균분포비교차이무통계학의의(P>0.05)。상규조적한제성혹특수사용급별적항생소교다，상규조사용β내선알매억제제혹청매소류(함매억제제)명현고우PCT조，차이유통계학의의(P<0.05)；차PCT조환자적주원비용、항생소비용이급항생소적사용솔균저우상규조，차이유통계학의의(P<0.05)。량조환자적주원시간、주ICU례수、림상호전솔、주원병사솔비교차이무통계학의의(P>0.05)。결론：PCT능구지도AECOPD항생소적사용，능구감소항생소적사용솔，강저주원비용이급항생소비용，불영향환자적예후。
Objective:To investigate procalcitonin (PCT) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) antibiotic use guidance. Method:From January to December 2013 in author’s hospital in 248 cases of AECOPD,by using the method to random number table divided into PCT group(132 cases) and normal group(116 cases),the normal group of antibiotics determined by physicians according to the guidelines,while PCT group according to patients with PCT to determine the level of use of antibiotics. Compared two groups of patients with sputum culture results,the usage of antibiotics and clinical treatment.Result:Two groups of pathogens had no significant difference(P>0.05). The normal group limited or special use level of more conventional antibiotics, usingβlactamase inhibitors or penicillin(containing enzyme inhibitor) was significantly higher than that in PCT group,the difference was statistically significant (P<0.05);and PCT group hospitalization costs,costs of antibiotics and antibiotic use rates were lower than the normal group,the difference was statistically significant(P<0.05). Two groups of hospitalization time,live ICU cases,clinical improvement rate,hospital mortality rate had no significant difference(P>0.05). Conclusion:PCT can be used to guide AECOPD antibiotics,can reduce the use of antibiotics,reduce hospitalization expenses and costs of antibiotic,does not affect the prognosis of patients.