国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2014年
20期
1540-1543
,共4页
张谨超%崔朝勃%黄蕾%刘淑红%王会青%亢洪山
張謹超%崔朝勃%黃蕾%劉淑紅%王會青%亢洪山
장근초%최조발%황뢰%류숙홍%왕회청%항홍산
降钙素原%老年心衰%肺部感染%重症医学科
降鈣素原%老年心衰%肺部感染%重癥醫學科
강개소원%노년심쇠%폐부감염%중증의학과
Procalcitonin%Elderly patients with heart failure%Pulmonary infection%Critical care medicine
目的 探讨血清降钙素原(PCT)水平在老年心衰患者抗感染治疗策略中的价值.方法 选取2013年1月至2014年2月本院住院的老年心衰患者共165例,随机分为常规治疗组(85例)和PCT指导治疗组(80例).常规治疗组根据患者临床症状和病情变化决定抗菌药物的使用,而PCT指导治疗组根据患者血清PCT浓度决定抗菌药物的使用.观察两组患者的临床有效率、住院病死率、住院时间、住院总费用、抗菌药物疗程、抗菌药物费用、二重感染率以及半年随访期间肺部感染的发生率.结果 常规治疗组和PCT指导治疗组在临床有效率(81.2％ vs 82.5％)、住院病死率(5.9％vs 5.0％)、半年随访期间肺部感染的发生率(32.9％ vs 31.3％)等方面差异均无统计学意义(P值均＞0.05);而PCT治疗组患者在住院总费用(5 854元vs 9 652元)、抗菌药物疗程(10.2 d vs 16.7 d)、抗菌药物费用(2 543元vs 3 646元)及二重感染率(2.5％vs 7.1％)等方面均低于常规治疗组(P值均＜0.05).结论 老年心衰患者在PCT指导下使用抗菌药物,能减少抗菌药物使用量,降低住院费用,降低二重感染的发生率.
目的 探討血清降鈣素原(PCT)水平在老年心衰患者抗感染治療策略中的價值.方法 選取2013年1月至2014年2月本院住院的老年心衰患者共165例,隨機分為常規治療組(85例)和PCT指導治療組(80例).常規治療組根據患者臨床癥狀和病情變化決定抗菌藥物的使用,而PCT指導治療組根據患者血清PCT濃度決定抗菌藥物的使用.觀察兩組患者的臨床有效率、住院病死率、住院時間、住院總費用、抗菌藥物療程、抗菌藥物費用、二重感染率以及半年隨訪期間肺部感染的髮生率.結果 常規治療組和PCT指導治療組在臨床有效率(81.2％ vs 82.5％)、住院病死率(5.9％vs 5.0％)、半年隨訪期間肺部感染的髮生率(32.9％ vs 31.3％)等方麵差異均無統計學意義(P值均＞0.05);而PCT治療組患者在住院總費用(5 854元vs 9 652元)、抗菌藥物療程(10.2 d vs 16.7 d)、抗菌藥物費用(2 543元vs 3 646元)及二重感染率(2.5％vs 7.1％)等方麵均低于常規治療組(P值均＜0.05).結論 老年心衰患者在PCT指導下使用抗菌藥物,能減少抗菌藥物使用量,降低住院費用,降低二重感染的髮生率.
목적 탐토혈청강개소원(PCT)수평재노년심쇠환자항감염치료책략중적개치.방법 선취2013년1월지2014년2월본원주원적노년심쇠환자공165례,수궤분위상규치료조(85례)화PCT지도치료조(80례).상규치료조근거환자림상증상화병정변화결정항균약물적사용,이PCT지도치료조근거환자혈청PCT농도결정항균약물적사용.관찰량조환자적림상유효솔、주원병사솔、주원시간、주원총비용、항균약물료정、항균약물비용、이중감염솔이급반년수방기간폐부감염적발생솔.결과 상규치료조화PCT지도치료조재림상유효솔(81.2％ vs 82.5％)、주원병사솔(5.9％vs 5.0％)、반년수방기간폐부감염적발생솔(32.9％ vs 31.3％)등방면차이균무통계학의의(P치균＞0.05);이PCT치료조환자재주원총비용(5 854원vs 9 652원)、항균약물료정(10.2 d vs 16.7 d)、항균약물비용(2 543원vs 3 646원)급이중감염솔(2.5％vs 7.1％)등방면균저우상규치료조(P치균＜0.05).결론 노년심쇠환자재PCT지도하사용항균약물,능감소항균약물사용량,강저주원비용,강저이중감염적발생솔.
Objective To explore the value of serum procalcitonin (PCT) in antiinfection therapies in elderly patients with heart failure.Methods One hundred and sixty-five elderly patients with heart failure hospitalized from January 2013 to February 2014 were randomly assigned into two groups:standard therapy group(n =85) and PCT-guided group (n =80).Patients in standard therapy group recerved antibiotics according to clinical symptoms,while patients in PCT-guided group received antibiotics according to serum PCT level.The clinical efficacy,hospital mortality,length of hospitalization,costs of hospitalization and antibiotics,period of antibiotics treatment,incidence of pulmonary infection within 0.5 year were observed and compared between two groups.Results There was no statistical difference in clinical efficacy (81.2％ vs 82.5％),hospital mortality (5.9％ vs 5.0％),and incidence of pulmonary infection within 0.5 year (32.9 ％ vs 31.3 ％) between standard therapy group and PCT-guided group (all P ＞0.05).The costs of hospitalization (5 854 yuan vs 9 652 yuan) and antibiotics (2 543 yuan vs 3 646 yuan),antibiotics treatment duration (10.2 days vs 16.7 days) and rate of superinfection (2.5％ vs 7.1％) in PCT-guided group were lower than those in standard therapy group (all P ＜ 0.05).Conclusions Serum PCT level could be used to optimize the anti infection therapies in elderly patients with heart failure,which may reduce antibiotic usage,hospitalization expenses,and superinfection risks.
