血清降钙素原水平测定在慢性阻塞性肺疾病急性加重期意义.docVIP

血清降钙素原水平测定在慢性阻塞性肺疾病急性加重期意义 　　doi：10.3969/j.issn.1007-614x.2014.17.67 　　摘要目的：探讨血清降钙素原水平测定在慢性阻塞性肺疾病急性加重期（AECOPD）的临床意义。方法：2013年1月-2014年1月收治AECOPD患者286例，随机分成观察组和对照组各143例，对照组患者在治疗第1天、4天、7天、10天、14天进行血常规检查，并根据临床症状、体征、实验室检测来判断是否需要应用抗生素治疗。观察组在对照组的基础上增加对血清PCT的检查，根据PCT检查结果确定是否使用抗生素。结果：观察组143例患者PCT阳性103例，阳性率72.0%，hs-CRP阳性85例，阳性率59.4%，比较差异有统计学意义（P0.05）。观察组使用抗生素（8.1±1.9）天，患者住院时间（11.2±19）天，二重感染7例（4.9%）；对照组使用抗生素（22.3±5.7）天，患者住院时间（22.2±7.8）天，二重感染34例（23.8%），两组比较差异有统计学意义（P0.05）。结论：血清降钙素原水平是判断是否使用抗生素的重要指标，对合理使用抗生素有着重要的临床意义。 　　关键词慢性阻塞性肺疾病降钙素原抗生素 　　The significance of determining serum procalcitonin level in patients with acute exacerbation of chronic obstructive pulmonary disease 　　Wu Zifeng 　　The Traditional Chinese Medicine Hospital of Liuyang City，Hunan 410300 　　AbstractObjective：To investigate the significance of determining serum procalcitonin level in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods：286 cases with AECOPD were selected from January 2013 to January 2014. They were randomly divided into the observation group and the control group with 143 cases in each.The control group were checked blood tests in 1，4，7，10，14 days，and to determine the need for antibiotic treatment according to the clinical symptoms， signs and laboratory test.The observation group were added serum PCT examination based on the control group treatment，and determined whether the use of antibiotics according to the PCT examination results.Results：In 143 cases of the observation group， 103 cases were PCT positive，and the positive rate was 72%.85 cases were hs-CRP positive，and the positive rate was 59.4%.There were significant difference（P0.05）.In the observation group，the average duration of antibiotics use was 8.1±1.9 days，and the hospitalization time was 11.2±19 days，7 cases of double infection，accounting for 4.9%.In the control group，the average duration of antibiotics use was 22.3±5.7 days，and the hospitalization time was 22.2±7.8 days，34 cases of double infecti