监测降钙素原水平指导AECOPD患者抗感染治疗的临床研究.pdfVIP

• 282 • 西南国防医药2016 年3 月第 26 卷第 3 期 ·临床论著· 监测降钙素原水平指导AECOPD 患者抗感染治疗的临床研究 李晓宁，周超，魏丽，王岸 [摘要] 目的 探讨监测慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者血清降钙素原(PCT)水平对指导临床抗感 染治疗的价值。方法将我院收治的AECOPD 患者 136 例随机分为，实验组 67 例，对照组 69 例。实验组动态监测 PCT 水平， 并据此指导临床治疗;对照组按常规经验性治疗。随访 1 年，比较两组患者首次再发 AECOPD 时间、发生频率、每次平均住院 时间、因加重转入ICU 治疗的比例、病死率等指标。结果实验组 PCT 水平在治疗好转后明显下降。实验组再发AECOPD 时间 较对照组明显延长(5.17 :tO.87)vs(4.39 :t0.65)个月，发生频率(2卫士0.34)vs(2.86:t0.46)例次、每次平均住院时间(14.73 :t4.67)vs (16.89:t5.42)d 均显著低于对照组(P 0.05) 。实验组和对照组分别有 5 例次和 14 例次因 COPD 急性加重而转入ICU 病房，差 异具有统计学意义(P 0.05)。两组病死率无统计学差异。结论监测 PCT 水平有利于早期预测 COPD 患者发生感染急性加重 风险，指导临床更有效地抗感染治疗。 [关键词]慢性阻塞性肺疾病;急性加重期;降钙素原;抗感染;治疗 中固分类号 R 563 文献标识码 A 文章编号 1∞4-0188( 2016 )03-0282-03 doi: 1O.3969/j.issn.l∞4-0188.却16.03.0 CliDiCal æøeareh OD 皿mitori鸣严ocalci阳inle叫8 for pidance of 8皿..mfective 也erapy OD pa画eDI8 wi也 AECOPD Li Xiaoning , Zhou Chao, Wei l.i, Wang An Department of Respiratory Medicine , Zhoupu Hospital of Pudong New District , Shanghai , 201318 , China [Ahøtract] Objective To investigate the guidance value of procalcitonin (PCT) levels in the anti-infective therapy on patients m出 acute exacerbation of COPD. Me也.odø 136 patients with ACOPD were randomly divided into experimental group (67 cases) and control group (69 cωes). PCT levels in the experimental group were dynamically monitored in order to provide guidance for the clinic. The control group received routine empiric therapy. The follow-up was made for 1 year. Comparison was made in the time to the first recurrence , frequency of recurrence , average stay, ICU ratio , and mortality rate between the two 伊oups. Reøultø PCT levels in the experimental group significantly decreased after the improvement by treatment. Compared wi由 the time to the first recuπ.ence in the control group，也at in the experimental group significantly p