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目的:分析老年重症肺炎患者降钙素原(PCT)的动态变化及其抗感染治疗的临床价值。方法:选取ICU的患者114例,将其分为治疗组(n=57)和对照组(n=57);对照组患者予常规治疗,根据患者临床症状、体征选用抗菌药物;治疗组患者给予监测血清PCT质量浓度、C-反应蛋白(CRP)和血常规(WBC)的变化,分析老年重症肺炎患者动态降钙素原(PCT)的变化及其临床价值。结果:114例患者中存活组患者为96例,非存活组患者为18例;非存活组患者在3,5和7 d的血清PCT和CRP值均明显高于存活组(P<0.05);PCT质量浓度与急性生理学和慢性健康状况采用APACHEⅡ评分,呈正相关(r=0.852,P<0.05);治疗组患者抗菌药物费用和使用强度(AUD)、住院天数、抗菌使用疗程,以及二重感染和药品不良反应(ADR)等指标均优于对照组(P<0.05)。结论:分析PCT值对临床老年重症肺炎患者预后的评估和优化抗菌药物的治疗,故PCT质量浓度的变化与抗菌药物的疗效具有一定的相关性。
Objective: To analyze the dynamic changes of procalcitonin (PCT) in elderly patients with severe pneumonia and the clinical value of anti-infective therapy. Methods: 114 patients with ICU were selected and divided into treatment group (n = 57) and control group (n = 57). Patients in control group were treated routinely and antibacterial drugs were selected according to clinical symptoms and signs of patients. Patients in treatment group were given Serum PCT concentration, C-reactive protein (CRP) and blood routine (WBC) were measured to analyze the changes and clinical value of dynamic procalcitonin (PCT) in elderly patients with severe pneumonia. Results: The survival rate of 96 patients in 114 patients and 18 patients in non - survivors group were significantly higher than those in survivors (P <0.05) at 3, 5 and 7 days. There was a positive correlation between PCT concentration and acute physiology and chronic health status by using APACHEⅡscore (r = 0.852, P <0.05). Antibiotics costs and intensity of use (ADR), days of hospitalization, antimicrobial treatment and double infection And adverse drug reaction (ADR) and other indicators were better than the control group (P <0.05). Conclusion: The analysis of the PCT value in the evaluation of the prognosis of elderly patients with severe pneumonia and the optimization of the treatment of antimicrobial agents. Therefore, the change of PCT mass concentration has a certain correlation with the efficacy of antimicrobial agents.