CAJ | 학술논문

目的：探讨降钙素原（PCT）是否可以指导慢性阻塞性肺疾病急性加重期（AECOPD）患者撤机。方法选择2010年1月到2014年3月吉化集团公司总医院重症监护病房（ICU）收治的因细菌感染诱发AECOPD需有创机械通气的患者，每日取静脉血监测PCT水平，自主呼吸试验（SBT）耐受良好者予以撤机拔管。撤机后密切观察48 h，以首次脱机成功与否将患者分为两组，比较两组患者PCT水平。结果共入选52例患者，脱机成功组38例，失败组14例。两组患者性别、年龄、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分等基线资料比较差异均无统计学意义（均P＞0.05）。成功组和失败组入院时PCT水平（μg/L）无显著差异（分别为5.33±1.35和5.37±1.34），撤机时PCT水平均有所降低（分别为1.37±0.39和1.74±0.42），且成功组PCT水平明显低于失败组（t＝2.971，P＝0.005）。结论 PCT可以作为一项撤机指标，用来指导AECOPD患者撤机时间的选择。
목적：탐토강개소원（PCT）시부가이지도만성조새성폐질병급성가중기（AECOPD）환자철궤。방법선택2010년1월도2014년3월길화집단공사총의원중증감호병방（ICU）수치적인세균감염유발AECOPD수유창궤계통기적환자，매일취정맥혈감측PCT수평，자주호흡시험（SBT）내수량호자여이철궤발관。철궤후밀절관찰48 h，이수차탈궤성공여부장환자분위량조，비교량조환자PCT수평。결과공입선52례환자，탈궤성공조38례，실패조14례。량조환자성별、년령、급성생이학여만성건강상황평분계통Ⅱ（APACHEⅡ）평분등기선자료비교차이균무통계학의의（균P＞0.05）。성공조화실패조입원시PCT수평（μg/L）무현저차이（분별위5.33±1.35화5.37±1.34），철궤시PCT수평균유소강저（분별위1.37±0.39화1.74±0.42），차성공조PCT수평명현저우실패조（t＝2.971，P＝0.005）。결론 PCT가이작위일항철궤지표，용래지도AECOPD환자철궤시간적선택。
Objective To investigate the possibility that procalcitonin (PCT) can predict the outcome of ventilator weaning in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The AECOPD patients caused by bacteria who received mechanical ventilation in intensive care unit (ICU)of the General Hospital of China National Petroleum Corporation in Jilin from January 2010 to March 2014 were retrospectively selected,and their venous blood PCT levels were monitored daily. When they had passed the spontaneous breathing trial(SBT),their breathing machine and trachea cannula were removed. Afterwards they were closely observed for 48 hours and divided into two groups:success and failure groups according to the outcome of the first weaning,and then the analysis of the PCT difference between the two groups was made. Results In the 52 patients enrolled,there were 38 patients in the success group and 14 patients in the failure group. The baseline information as age,sex,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score between the two groups showed no significant difference(all P>0.05). There was no statistical significant difference in PCT level(μg/L) between success and failure groups when they were admitted(5.33±1.35 and 5.37±1.34,respectively). When they were weaning,the PCT levels of both groups had reduced to some extent(1.37±0.39 and 1.74±0.42,respectively), and the success group was lower than that in the failure group(t=2.971,P=0.005). Conclusion PCT level can be used as a predictive index to guide the time for ventilator weaning in patients with AECOPD.