摘要
目的评价降钙素原(PCT)的水平指导ICU老年患者临床抗生素的使用价值。方法对ICU患者细菌感染的42例老年患者随机分为常规治疗组和PCT指导治疗组。在传统的疗法的基础上,常规组由医师按照常规抗生素治疗指南的决定使用抗生素治疗,血清PCT水平指导组,按照PCT水平,以决定是否使用抗生素。在血清PCT>0.25μg/mL,抗生素治疗,PCT<0.25μg/mL,非抗生素治疗。使用抗生素治疗后比较临床疗效,抗生素利用率,抗生素治疗时间,两组患者炎症标志物。结果结果两组经治疗后,PCT组患者白细胞、中性粒细胞、CRP与常规组差异无统计学意义;两组治疗后,炎症指数明显低于治疗前,PCT组值较治疗前降低。与此同时,抗生素使用时间,PCT组短于常规组,差异有统计学意义;抗生素使用率是47.6%和90.5%,差异有统计学意义,常规组显著高于PCT组。结论在ICU,参考血清PCT浓度指导老年患者抗菌药物使用,可以达到更好的治疗效果,减少抗生素使用量,减少使用抗生素治疗疗程。PCT水平的动态监测可以判断病情变化,随着病情逐步改善,PCT值逐渐恢复正常。
Objective To evaluate the value of procalcitonin（PCT） levels guiding the clinical use of antibiotics at ICU elderly patients.Methods The 42 aged patients with bacterial infection and ICU were randomly assigned to conventional treatment group and PCT guidance treatment group.Beside conventional therapy,conventional therapy group were given antibiotics by physician in accordance with the decision to antibiotic treatment guidelines,and the PCT levels of PCT guidance group were measured to decide whether were given antibiotics,the antibiotic treatment if PCT 0.25μg/mL and the non-antibiotic treatment if PCT 0.25μg/mL.The using time,clinical efficacy,utilization rates and inflammatory markers of the two groups were all compared after treatment of antibiotic.Results After treatment,white blood cells,neutrophils and CRP were no significant difference between PCT group and the conventional group.The inflammatory parameters of two groups before treatment were significantly lower than before treatment.Meanwhile,antibiotic using time,the conventional group was longer than PCT group,and the difference has statistical sense.Antibiotic usage ratioes of two groups were 90.5% and 47.6%,and the difference was statistically significant.That of PCT group was significantly lower than conventional group.Conclusion To antimicrobial treatment of elderly patients in ICU,in the reference of PCT levels,you can achieve better therapeutic effect and reduce antibiotic usage,reduce the use of antibiotics treatment.Dynamic monitoring of PCT levels can predict their condition,with the PCT level decreasing,the condition improved gradually to normal.
出处
《哈尔滨医药》
2011年第2期88-89,共2页
Harbin Medical Journal
关键词
降钙素原
老年患者
抗菌治疗
Procalcitonin
Elderly patients
Antibiotic treatment
