CAJ | 학술논문

目的：通过对照研究利用血清降钙素原( Procalcitonin,PCT)水平判断社区获得性肺炎( commu-nity-acquired pneumonia,CAP)终止抗菌药物治疗的时机的可行性。方法220例CAP住院患者随机分为两组：实验组140例,对照组80例。实验组在入院后24 h内采集静脉血清进行PCT检查,血清PCT>0．5 ng/ml者隔日进行采血检查,当PCT<0．5 ng/ml或者下降超过峰值的80%时停用抗菌药物；对照组则根据医生临床判断决定停用抗菌药物时机。结果共207例患者完成临床试验。实验组抗菌药物使用天数、住院天数明显低于对照组(6．7±1．3、7．2±1．4 vs 8．6±1．7、9．1±1．6),(P<0．05)；实验组住院总费用明显低于对照组(4531±708．3 vs 6067±912．7),(P<0．05)；两组肺炎复发率无差异(P>0．05)。结论 PCT是判断CAP抗菌治疗终止时机的良好指征,此方法具有临床可行性。
목적：통과대조연구이용혈청강개소원( Procalcitonin,PCT)수평판단사구획득성폐염( commu-nity-acquired pneumonia,CAP)종지항균약물치료적시궤적가행성。방법220례CAP주원환자수궤분위량조：실험조140례,대조조80례。실험조재입원후24 h내채집정맥혈청진행PCT검사,혈청PCT>0．5 ng/ml자격일진행채혈검사,당PCT<0．5 ng/ml혹자하강초과봉치적80%시정용항균약물；대조조칙근거의생림상판단결정정용항균약물시궤。결과공207례환자완성림상시험。실험조항균약물사용천수、주원천수명현저우대조조(6．7±1．3、7．2±1．4 vs 8．6±1．7、9．1±1．6),(P<0．05)；실험조주원총비용명현저우대조조(4531±708．3 vs 6067±912．7),(P<0．05)；량조폐염복발솔무차이(P>0．05)。결론 PCT시판단CAP항균치료종지시궤적량호지정,차방법구유림상가행성。
Objective To investigate the feasibility of serum procalcitonin ( PCT ) levels determining the timing of antibiotic therapy termination in patients with community-acquired pneumonia ( CAP) by randomised con-trolled trial. Methods 220 inpatients with pneumonia were randomly divided into two groups:140 patients in the experimental group and 80 patients in the control group. In the experimental group, serum PCT was detected within 24 hours. If their serum PCT>0. 5ng/ml they were checked every other day for blood later. Antibiotic treatment were adviced to stop in case PCT decreased more than 80% of its peak level or decreased below a value of 0. 5 ng/ml. In the control group, antibiotics termination was according to clinical judgment of the doctors’ decision. Results 207 patients completed the clinical trials. The days of antibiotics and duration of hospitali stay in the experimental group were significantly lower in the experimental group than in the control grou p(6. 7 ± 1. 3, 7. 2 ± 1. 4 vs 8. 6 ± 1. 7, 9. 1 ± 1. 6) (P<0. 05). The total cost of hospital stay in the experimental group was significantly lower than that in the control group (4531 ±708.3 vs 6067 ±912.7) (P<0.05). There was no significant difference in relapse rate of pneumonia between the two groups (P>0. 05). Conclusion PCT is a good indication to judge the timing of termi-nation antibiotic therapy in CAP.