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目的:探讨联合MDRA评分和PCT动态变化对诊治侵袭性真菌感染(IFI)成功率的影响。方法:回顾性分析2013年4月-2014年4月重症监护病房(ICU)收治的真菌感染患者32例的临床资料,利用美国西弗吉尼亚大学医学院建立的真菌感染危险因素评分系统(Multi-disease Risk Assessment Program,MDRA)评分标准进行评分,观察MDRA评分和PCT动态变化对诊治侵袭性真菌感染的价值。结果:32例真菌感染患者的MDRA评分均>30分,符合经验治疗的标准,但PCT值轻度升高并处于低水平及动态检测发现PCT值进行性降低的病例抗真菌治疗有效,而PCT值高,及进行性升高的病例抗真菌治疗无效。结论:侵袭性真菌感染的诊治不能教条地照搬MDRA评分标准,结合PCT的动态检测值水平有助于提高诊治的正确率。
Objective: To investigate the effect of joint MDRA score and dynamic change of PCT on the success rate of diagnosis and treatment of invasive fungal infection (IFI). Methods: The clinical data of 32 patients with fungal infection admitted to intensive care unit (ICU) from April 2013 to April 2014 were analyzed retrospectively. The risk factors for fungal infection (Multi-disease score system) established by West Virginia University School of Medicine were retrospectively analyzed. Risk Assessment Program (MDRA) was used to evaluate the value of MDRA score and dynamic change of PCT in diagnosis and treatment of invasive fungal infection. Results: The 32 patients with fungal infection had MDRA scores> 30, which met the criteria of empirical treatment. However, the PCT values were slightly elevated and at low level, and the anti-fungal therapy with dynamic reduction of PCT value was detected dynamically. PCT Anti-fungal therapy is not effective in cases of high value and progressive increase. Conclusion: The diagnosis and treatment of invasive fungal infection can not be dogmantly implicated in the MDRA score. Combined with the dynamic detection value of PCT, it is helpful to improve the accuracy of diagnosis and treatment.