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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、14d APACHEⅡ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.“,”AIM To explore the value of combined serum procalcitonin (PCT) and C-reactive protein (CRP) in treatment of pyrexia after heart failure.METHODS One hundred and sixty-three patients with heart failure were randomly divided into two groups:standard therapy group (n =81) and PCT and CRP-guided group (n =82).Standard therapy group received antibiotics,while PCT and CRP-guided group were treated with antibiotics according to PCT and CRP levels.The rate of antibiotics use,the costs of hospitalization and antibiotics,clinical efficacy,APACHE Ⅱ score on 14th day,and the length of hospitalization were observed.RESULTS The positive rate of bacteria in patients was 29.8％.Clinical efficacy,APACHE Ⅱ score on 14th day and the length of hospitalization were similar between the two groups.The rate of antibiotics use and the costs of hospitalization and antibiotics in PCT and CRP-guided groups were lower than those in the standard therapy group.CONCLUSIONS PCT combined with CRP reduces the use of antibiotics and costs of hospitalization and antibiotics in treatment of pyrexia after heart failure.