论文部分内容阅读
目的通过动态检测支气管扩张急性加重期患者的血清降钙素原(PCT)变化,了解其指导诊治的价值。方法收集2013年5月至2015年10月共60例支气管扩张急性加重期患者,常规行诱导痰细菌培养,并将其随机分为两组:观察组30例,动态检测PCT,血清PCT≥0.25μg/L时使用抗生素,PCT<0.25μg/L则停用抗生素;对照组30例,不检测PCT,根据患者临床症状决定抗生素的使用。比较两组患者的临床疗效、抗生素使用天数、住院时间、30 d内再住院率。观察血清PCT水平与痰培养、APACHEⅡ评分的关系。结果两组患者临床有效率、30 d内再住院率比较,差异未见统计学意义(P>0.05)。两组患者抗生素使用天数和住院天数比较差异有统计学意义(P<0.01)。观察组中痰培养细菌结果阳性者入院后第1天血清PCT水平明显高于培养结果阴性者(P<0.01);相关分析表明患者入院后第1天血清PCT水平与APACHEⅡ评分呈正相关(r=0.536,P<0.05)。结论动态检测降钙素原对支气管扩张急性加重期患者的诊治有一定指导意义。
OBJECTIVE: To dynamically detect the changes of procalcitonin (PCT) in patients with acute exacerbation of bronchiectasis, and to evaluate the value of its guidance and treatment. Methods A total of 60 patients with acute exacerbation of bronchiectasis from May 2013 to October 2015 were enrolled in this study. Bacterial culture of sputum was performed routinely and divided into two groups randomly: observation group (30 cases), PCT, serum PCT≥0.25 Antibiotics were used at μg / L and antibiotics were discontinued at PCT <0.25 μg / L. In the control group, 30 cases were not detected by PCT, and the use of antibiotics was determined according to the patient’s clinical symptoms. The clinical efficacy, antibiotic days, hospital stay, and readmission rates within 30 days were compared between the two groups. The relationship between serum PCT level and sputum culture and APACHEⅡscore was observed. Results There was no significant difference between the two groups in the clinical efficiency and the readmission rate within 30 days (P> 0.05). There was significant difference between the days of antibiotic use and days of hospitalization in both groups (P <0.01). The level of serum PCT in the observation group was significantly higher on the first day after admission than that on the first day after admission (P <0.01). The correlation analysis showed that the serum PCT level was positively correlated with the APACHEⅡ score on the first day after admission (r = 0.536, P <0.05). Conclusions The dynamic detection of procalcitonin has some guiding significance in the diagnosis and treatment of patients with acute exacerbation of bronchiectasis.