动态监测血清降钙素原水平在优化全身性感染患者抗菌治疗策略中的价值

目的:评估动态监测血清降钙素原水平(PCT)在优化全身性感染患者抗菌治疗策略中的价值。方法:选取2015年4月~2015年12月全身性感染患者85例,随机分为常规组42例和PCT组43例。常规组按照《抗菌药物临床应用指导原则(2015年版)》决定抗生素疗程;PCT组在抗生素治疗后第3、5、7、10、14 d监测血清PCT水平,若PCT0.25 ng/mL停用抗生素、PCT≥0.25 ng/mL继续使用抗生素。分别比较两组患者间一般情况、传统全身炎症性反应指标及抗生素使用的种类、时间、费用以及预后的差异。结果:两组患者间治疗前后传统全身炎症性反应指标无明显差异(P0.05);两组患者间常用的抗生素种类并无明显统计学差异(P0.05);PCT组患者抗生素使用的天数为(9.9±3.9)d,明显少于常规组的(13.9±5.2)d,差异有统计学意义(P0.05);PCT组患者抗生素日均费用为(422.39±139.9)元,明显低于常规组的(514.78±155.2)元,差异有统计学意义(P0.05);两组患者间停用抗生素后14天后全身感染复发率以及28天病死率无明显统计学差异(P0.05)。但PCT组患者总住ICU时间明显少于常规组,差异有统计学意义(P0.05)。结论:动态监测血清PCT水平在优化全身性感染患者抗菌治疗策略中具有重要价值。

Value of Dynamic Monitoring the Level of SerumCalcitonin in Original Optimization of Systemic Infection in Patients with Antimicrobial Treatment Strategies

Objective:To evaluate the value of dynamic monitoring the level of serum calcitonin in original optimization of systemic infection in patients with antimicrobial treatment strategies.Methods:85 cases of patients with systemic infection during April 2015 to December 2015were selected, they were randomly divided into regular group for 42 cases and the PCT group for 43 cases. according to the principles of clinical application of antibacterial drugs guidance (2015 edition), regular group was decided to antibiotics; in PCT group, after antibiotic treatment group 3, 5, 7, 10, 14 d serum PCT level was monitored, if the PCT < 0.25 ng/mL stop using antibiotics, PCT acuity 0.25 ng/mL continued use of antibiotics. general condition, traditional index of systemic inflammatory response, and antibiotic use, time, cost, and the prognosis of the kinds of differences were compared between two groups.Results:Traditional systemic inflammatory response index before and after treatment in two groups has no obvious difference (P>0.05); there was no significant statistical difference for commonly used types of antibiotics between two groups (P>0.05); the number of days of antibiotic use in PCT group was (9.9± 3.9) d, was significantly less than regular group (13.9± 5.2) d, the difference was statistically significant (P<0.05); average daily cost of RMB in PCT group was (422.39± 139.9) yuan, significantly lower than regular group (514.78± 155.2) yuan, the difference was statistically significant (P<0.05); there were no significant statistical difference for patients stop using antibiotics in 14 days after 28 days systemic infection recurrence rate and mortality between two groups (P>0.05). But always live time in ICU in PCT group was obviously less than regular group,the difference was statistically significant (P<0.05).Conclusion:Dynamic monitoring serum PCT level has important value in optimizing antibacterial treatment strategies in patients with systemic infection.