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目的评估慢性阻塞性肺疾病(COPD)急性加重患者血清降钙素原(PCT)水平变化的临床意义。方法回顾性分析本院2012年12月~2013年12月期间71例慢性阻塞性肺疾病急性加重的患者。将随机分成PCT组(36例)和经验治疗组(35例)。PCT组根据血清PCT水平决定抗生素的使用,经验治疗组由医师根据临床经验结合患者症状、血常规和和影像学检查结果决定抗生素的使用。比较两组患者抗生素使用率、使用时间、住院病死率、住院时间。结果两组住院病死率、住院时间比较差异无统计学意义,但PCT组的抗生素使用率和使用时间明显少于经验治疗组(P<0.05)。结论以PCT水平指导COPD急性加重患者抗生素治疗,有利于缩短抗生素使用时间,促进临床药物合理利用。
Objective To evaluate the clinical significance of serum procalcitonin (PCT) levels in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A retrospective analysis of our hospital from December 2012 to December 2013 71 cases of acute exacerbation of chronic obstructive pulmonary disease patients. The patients were randomly divided into the PCT group (36 cases) and the experience treatment group (35 cases). The PCT group determined the use of antibiotics based on the level of serum PCT, and the empirical treatment group determined the use of antibiotics based on clinical experience by the physician in combination with the patient’s symptoms, blood tests, and imaging findings. The antibiotic usage, time of use, in-hospital mortality and length of hospital stay were compared between the two groups. Results There was no significant difference in hospital mortality and hospital stay between the two groups. However, the antibiotic use rate and duration of use in the PCT group were significantly less than those in the experimental group (P <0.05). Conclusion PCT level guide patients with acute exacerbation of COPD antibiotics, will help shorten the use of antibiotics, and promote the rational use of clinical drugs.