【摘要】 目的观察血清降钙素原(PCT)联合C反应蛋白(CRP)检测指导老年肺炎患者抗菌治疗的临床效果。方法选取我院内科2015年1~12月收治的186例老年肺炎住院患者,按随机数表法分为对照组和观察组,每组各93例。对照组根据医生临床经验决定抗菌素的使用,观察组则根据PCT及CRP监测情况决定抗菌药物使用。比较两组患者的临床治疗效果及不良事件发生情况。结果观察组患者的肺部啰音消失时间、影像学转阴时间和痰培养转阴时间分别为(5.1±1.1)d、(6.3±1.4)d和(6.5±1.4)d,均明显少于对照组的(10.6±2.4)d、(12.5±2.5)d、(12.7±2.6)d,差异均有统计学意义(P<0.05);观察组患者的白细胞计数、C反应蛋白含量和PCT含量分别为(6.5±1.2)×109/L、(0.415±0.024)ng/m L和(5.482±1.032)ng/m L,均明显优于对照组的(7.2±1.4)×109/L、(0.542±0.035)ng/m L和(6.812±1.248)ng/m L,差异均有统计学意义(P<0.05);观察组患者的抗生素使用时间、住院时间和住院经费分别为(7.1±1.2)d、(9.1±3.2)d和(6 575.4±240.6)元,均明显少于对照组的(11.8±2.2)d、(13.8±4.1)d、(10 426.5±312.4)元,差异均有统计学意义(P<0.05);观察组患者细菌耐药1例、菌群失调0例、二重感染1例,对照组分别为8例、7例、10例,观察组患者总不良事件发生率为2.2%,低于对照组的26.9%,差异有统计学意义(P<0.05)。结论降钙素原联合C反应蛋白指导老年肺炎患者抗菌治疗可显著提高治疗效果,减少抗生素使用时间、住院时间及住院经费,值得临床推广应用。更多还原

【Abstract】 Objective To observe the clinical effect of serum procalcitonin combined with C-reactive protein detection for guiding the antibacterial therapy in elderly patients with pneumonia. Methods A total of 186 elderly patients with pneumonia in our hospital from January 2015 to September 2015 were selected and randomly divided into control group and observation group based on the random number table, with 93 patients in each group. The control group according to the doctor clinical experience decided to stop using antibacterial treatment, and the observation group according to the monitored of PCT and CRP level applied antibacterial drugs. The clinical therapeutic effect and adverse events were compared between the two groups. Results The lung sound disappear time, turn and imaging time and sputum culture turn time of observation group were significantly earlier than those of control group [(5.1±1.1) d vs(10.6±2.4) d,(6.3±1.4) d vs(12.5±2.5) d,(6.5±1.4) d vs(12.7±2.6) d, P<0.05]. The white blood cell count, C-reactive protein content and PCT levels of observation group were significantly better than those of the control group [(6.5±1.2)×109/L vs(7.2±1.4)×109/L,(0.415±0.024) ng/m L vs(0.542±0.035) ng/m L,(5.482±1.032) ng/m L vs(6.812±1.248) ng/m L, P<0.05]. The antibiotic use time, length of hospital stay and hospitalization expenses in observation group were significantly less than those in the control group [(7.1±1.2) d vs(11.8±2.2) d,(9.1±3.2) d vs(13.8±4.1) d,(6 575.4±240.6) yuan vs(10 426.5±312.4) yuan,P<0.05]. In the observation group, there were 1 case of bacterial drug resistance, 0 case of dysbacteriosis, 1 case of double infection in the obserration group and 8 cases, 7 cases, 10 cases in the control group. The incidence of adverse event was significantly lower than control group(2.2% vs 26.9%, P<0.05). Conclusion Procalcitonin combined with C-reactive protein detection for guiding the antibacterial therapy in elderly patients with pneumonia can significantly improve the treatment effect, and reduce the use of antibiotics, hospitalization time and hospitalization expenses. It is worthy to be clinically popularized and applied.更多还原