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目的:探讨血清降钙素原(PCT)指导慢性阻塞性肺疾病急性加重期(AECOPD)患者抗菌药物应用的价值。方法:选取本院呼吸内科AECOPD患者79例,采用随机数字表法将患者分为两组:PCT指导组40例,根据血清PCT水平指导抗菌药物应用;常规组39例,由主管医师根据病情程度、外周血白细胞(WBC)计数与临床症状指导抗菌药物应用。结果:两组患者的临床有效率、加重率、病死率及住院时间比较,差异无统计学意义(P>0.05),PCT指导组患者双重感染率明显低于常规组(P<0.05)。PCT指导组抗菌药物应用时间明显短于常规组(P<0.05),抗菌药物费用与住院费用明显低于常规组(P<0.05)。结论:血清PCT水平检测在AECOPD患者抗菌药物应用中具有重要的指导价值。
Objective: To investigate the value of serum procalcitonin (PCT) in guiding the use of antimicrobial agents in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Seventy-nine patients with AECOPD in our department were divided into two groups according to the random number table: 40 cases were guided by PCT. Antibiotics were applied according to the level of serum PCT. In the routine group, 39 cases were treated by the competent physician according to the degree of illness , Peripheral white blood cell (WBC) count and clinical symptoms guide the use of antimicrobial agents. Results: There was no significant difference in clinical efficiency, exacerbation rate, case fatality rate and hospital stay between the two groups (P> 0.05). The double infection rate in the PCT group was significantly lower than that in the conventional group (P <0.05). The application time of antibacterials in the PCT group was significantly shorter than that in the conventional group (P <0.05), and the cost of antimicrobial drugs and hospitalization was significantly lower than that of the conventional group (P <0.05). Conclusion: The detection of serum PCT level has an important guiding value in the application of antimicrobial agents in AECOPD patients.