降钙素原检测指导发热原因待查患者抗菌药物合理使用的研究及临床意义-药理学专业论文.docxVIP

- - PAGE 10 - 关键词：降钙素原；发热；抗菌药物 The research and clinical significance of procalcitonin in guiding fever of unknown origin patients’ antimicrobial reasonable use Abstract：Objective：1.Through the determination of serum procalcitonin (PCT), high sensitive C reactive protein (sCRP), white blood cell count (WBC), neutrophil ratio (N%), to evaluate the diagnostic value of bacterial infection in fever patients ,and provide reference index for early discrimination of the severity of illness , treatment options and the prognosis of the disease.2. To study whether there is correlation between PCT and pathogenic microbial species ,and, to explore the possibility of identifying what kind of bacteria infection (G- bacteria, G+ bacteria, fungi) .3.Evaluation of procalcitonin (PCT) to guide antimicrobial treatment strategies to optimize the value in the use of antibiotics in fever patients , in order to assess whether serum PCT levels can be a simple and effective experimental chamber indicators to guide the rational use of antibiotics in fever patients. Methods ：1. 71 cases of fever hospitalized patients in the department of Respiratory Medicine were randomly divided into 2 groups : PCT group (n = 41) and control group ( n = 30 ) from July 2012 to January 2013.2.In the PCT group, the serum PCT was detected on admission and after every 3 days ( 1,4,7,10 days),patients received antibiotics or not were depended on the value of PCT. In the control group, clinicians determine the use of antibiotics in patients with symptoms , signs, and other laboratory examinations and Guide, Without reference to the PCT values. At the same time, bacterial culture of sputum 、 blood , and other laboratory indexes such as high sensitivity C reactive protein (sCRP), white blood cell count (WBC), neutrophil ratio (N%) were detected in two groups. 3.The treatment after 28d as the endpoint of the study, we recorded and compared between the two groups of patients with antibiotic use, duration