CAJ | 학술논문

目的：评价降钙素原（PCT ）联合标准方法在指导儿童社区获得性肺炎（CAP）抗菌药物治疗中的价值。方法对190例可疑合并细菌感染的小儿非重症病毒性肺炎进行回顾性分析。分为联合方法组和标准治疗组，联合方法组为101例，按PCT浓度监测联合我国目前儿童CAP管理指南的方法指导使用抗菌药物，当P CT＜0．25μg/L且临床可疑细菌感染及PC T＞0．25μg/L者均使用抗菌药物；当PC T小于0．25μg/L且临床无伴细菌感染者予停药。标准治疗组89例，单独按CAP指南标准使用抗菌药物。两组均至少使用抗菌药物3 d后再次评估。最终分析抗菌药物的使用情况及临床疗效。结果与标准治疗组比较，联合方法组抗菌药物处方使用率明显降低[（4．9±1．4）dvs．（6．8±2．8）d]，并且其抗菌药物使用时间及抗菌药物不良反应发生率也更少（2．0％ vs．20．0％），以上两组各指标比较差异均有统计学意义（ P＜0．05）。两组住院时间及呼吸道症状复发率差异均无统计学意义（P＞0．05）。结论 PCT联合标准方法能明显减少儿童CAP抗菌药物的使用而未影响临床疗效，有助于更加合理使用抗菌药物。
목적：평개강개소원（PCT ）연합표준방법재지도인동사구획득성폐염（CAP）항균약물치료중적개치。방법대190례가의합병세균감염적소인비중증병독성폐염진행회고성분석。분위연합방법조화표준치료조，연합방법조위101례，안PCT농도감측연합아국목전인동CAP관리지남적방법지도사용항균약물，당P CT＜0．25μg/L차림상가의세균감염급PC T＞0．25μg/L자균사용항균약물；당PC T소우0．25μg/L차림상무반세균감염자여정약。표준치료조89례，단독안CAP지남표준사용항균약물。량조균지소사용항균약물3 d후재차평고。최종분석항균약물적사용정황급림상료효。결과여표준치료조비교，연합방법조항균약물처방사용솔명현강저[（4．9±1．4）dvs．（6．8±2．8）d]，병차기항균약물사용시간급항균약물불량반응발생솔야경소（2．0％ vs．20．0％），이상량조각지표비교차이균유통계학의의（ P＜0．05）。량조주원시간급호흡도증상복발솔차이균무통계학의의（P＞0．05）。결론 PCT연합표준방법능명현감소인동CAP항균약물적사용이미영향림상료효，유조우경가합리사용항균약물。
Objective To evaluate procalcitonin(PCT) measurement combined with standard therapy in guid-ing antibiotic therapy in children with community acquired pneumonia (CAP) .Methods The datas of 190 hospitalized children with uncomplicated CAP diagnosed as viral infection and suspected bacterial infection were retrospectively collected and analyzed .Among them ,101 patients belonged to combined method group ,who initiated antibiotics on basis of PCT concentration and current guidelines for the management of CAP in Chinese children .Antibiotics was recommended to be used when PCT <0 .25 μg/L but suspected bacterial infections in clinic or PTC ≥0 .25 μg/L ,u-sing of antibiotics was discouraged while PTC<0 .25 μg/L and no infection .Other 89 patients belonged to standard therapy group received antibiotics according to current guidelines alone .Reevaluation was did after antibiotic therapy at least three days in both groups .The use of antibiotics and clinical outcome was analyzed at last .Results Compared with standard group ,the combined method group received significantly fewer antibiotic prescriptions (P<0 .05) ,were exposed to antibiotics for a shorter time[(4 .9 ± 1 .4) vs (6 .8 ± 2 .8)] ,and experienced fewer antibiotic associated ad-verse effects(2 .0% vs 20 .0% ,P<0 .05) .There was no significant differences between groups in length of hospitali-zation and the proportion of children with recurrent infection symptoms requiring antibiotic treatment (P> 0 .05) . Conclusion The combined approach for children with CAP can markedly reduced antibiotic use without compromi-sing efficacy ,which contribute to the rational use of antibiotics .