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目的 评价联合检测血清降钙素原(PCT)与C-反应蛋白（CRP）对心力衰竭发热患者治疗的效果。方法 符合入选标准的163例患者被随机分为对照组(n=81)及PCT联合CRP组(n=82)；对照组入院后给予抗生素治疗，PCT联合CRP组依据PCT和CRP浓度决定是否使用抗生素，记录2组患者抗生素使用率、抗生素费用、住院总费用、临床有效率、14dAPACHEⅡ评分及住院时间并进行比较。结果 细菌培养阳性率30%; 2组患者PCT和CPR浓度较正常值均有不同程度增高，对照组PCT和CPR分别为(0.29±0.07)μg/L和(45±18)mg/L，PCT联合CRP组分别为(0.28±0.09)μg/L和(47±18)mg/L(P>0.05)。PCT联合CRP组抗生素使用率、住院总费用、抗生素费用明显著低于对照组（分别为P<0.01,P<0.05和P<0.05）。2组患者临床有效率、14d APACHEⅡ评分、住院时间之间比较无显著差异。结论 联合检测血清中 CRP与PCT浓度，有利于指导心力衰竭发热患者使用抗生素，减低住院费用。
Objective To evaluate the efficacy of combined detection of serum procalcitonin (PCT) and C-reactive protein (CRP) in the treatment of patients with fever due to heart failure. Methods 163 eligible patients were randomly divided into control group (n = 81) and PCT combined with CRP group (n = 82). The control group was given antibiotics after admission and the PCT combined with CRP group decided whether to use Antibiotics, antibiotic usage, antibiotic cost, total cost of hospitalization, clinical efficiency, 14-dayAPACHEⅡscore and hospital stay were recorded and compared. Results The positive rate of bacterial culture was 30%. The concentrations of PCT and CPR in both groups were all higher than those in the normal group. The PCT and CPR in control group were (0.29 ± 0.07) μg / L and (45 ± 18) mg / L, respectively. The combined CRP group was (0.28 ± 0.09) μg / L and (47 ± 18) mg / L, respectively (P> 0.05). Antibiotic use, total cost of hospitalization, and antibiotics were significantly lower in the PCT combined CRP group than in the control group (P & lt; 0.01, P & lt; 0.05 and P & lt; 0.05, respectively). There was no significant difference in clinical efficiency, 14-day APACHEⅡscore and hospital stay between the two groups. Conclusions Combined detection of serum CRP and PCT concentrations is beneficial to guide the use of antibiotics in patients with fever due to heart failure and reduce hospitalization costs.