降钙素原指导社区获得性肺炎抗菌治疗终止的应用研究.pdfVIP

1366 临床肺科杂志　 2014年8月　 第19卷第8期 降钙素原指导社区获得性肺炎抗菌治疗终止的应用研究 曾祥伯　 邓建华　 贵建平　 何东　 陈剑波　 李娜 　 　 【摘要】　 目的　 通过对照研究利用血清降钙素原(Procalcitonin,PCT)水平判断社区获得性肺炎(commu- nity-acquired pneumonia,CAP)终止抗菌药物治疗的时机的可行性。 方法　 220 例 CAP住院患者随机分为两 组:实验组140例,对照组80例。 实验组在入院后24 h 内采集静脉血清进行PCT检查,血清PCT0．5 ng/ ml 者隔日进行采血检查,当PCT0．5ng/ ml或者下降超过峰值的80%时停用抗菌药物;对照组则根据医生临床 判断决定停用抗菌药物时机。 结果　 共207例患者完成临床试验。 实验组抗菌药物使用天数、住院天数明显 低于对照组(6．7±1．3、7．2±1．4 vs 8．6 ±1．7、9．1±1．6),(P 0．05);实验组住院总费用明显低于对照组 (4531±708．3 vs 6067±912．7),(P0．05);两组肺炎复发率无差异(P 0．05)。 结论　 PCT是判断CAP抗 菌治疗终止时机的良好指征,此方法具有临床可行性。 　 　 【关键词】　 降钙素原;社区获得性肺炎;抗菌药物 Research onprocalcitonin-guidedantibiotictreatmentterminationincommunity-acquiredpneumonia　 ZENG Xiang-bo,DENGJian-hua,GUI Jian-ping,HEDong,CHEN Jian-bo,LI Na　 Department of Respiratory Medicine, the Second Peoples Hospital of HunanProvince,Changsha,Hunan　 410007,China 【Abstract】　 Objective　 To investigate the feasibility of serum procalcitonin (PCT) levels determining the timing of antibiotic therapy termination in patients with community-acquired pneumonia (CAP) by randomised con- trolled trial. Methods　 220 inpatients with pneumonia were randomly divided into two groups:140 patients in the experimental group and80 patients in the control group. In the experimental group,serum PCT was detected within 24 hours. IftheirserumPCT0．5ng/ mltheywerecheckedeveryotherdayforbloodlater. Antibiotictreatmentwere adviced to stop in case PCT decreasedmorethan80% of itspeaklevel or decreasedbelow avalueof0．5 ng/ ml. In the control group,antibiotics termination was according to clinicaljudgment of the doctors’decision. Results　 207 patients completed the clinical trials. The days of antibiotics and duration of hospitali stay in the experimental group were significantly lower intheexperime