摘要
目的:评价动态监测血清降钙素原(procalcitonin,PCT)在指导下呼吸道感染抗菌治疗中的临床价值。方法:选取90例医院获得性下呼吸道感染患者,根据应用抗生素的最终临床指标分为对抗生素治疗有效组(A组)和对抗生素治疗无效组(B组),观察确诊感染后第1、3、5、7d两组患者的血清PCT水平变化,并采用ROC曲线下面积观察PCT评估抗菌疗效的价值。结果:两组患者确诊感染后的第1d血清PCT水平比较无明显差异(P>0.05);而第3、5、7d A组患者血清PCT水平逐渐下降,而B组患者PCT水平则明显升高,两组比较有统计学差异(P<0.05)。第1、3、5、7d PCT水平指示抗菌无效的ROC曲线下面积分别为0.447、0.716、0.981、1.000,其中第3、5、7d PCT的ROC曲线下面积与第1d PCT的ROC曲线下面积比较差异均有显著性(P<0.05);抗生素治疗第5d,以PCT水平3.095μg/L为截点,判断抗生素治疗无效的灵敏度和特异性分别为97.4%和91.0%。结论:在医院获得性下呼吸道感染抗菌治疗过程中,动态监测PCT水平可作为优化抗生素治疗的有效指标。
Objective To evaluate the clinical significance of PCT in guiding the optimizing antibiotic treatment strategy for pa- tients with lower respiratory tract infections. Methods 90 patients with hospital-acquired lower respiratory tract infection were selected and according to final clinical indicators of antibiotics into andbiolic Ireatment group （ group A） and the antibiotic therapy group （ B）, the PCT levels were observed after the first, 3th, 5th ,7th days in the two groups with the diagnosis of infection and the clinical value of PCT for assessing the value of antimicrobial efficacy by the area under the ROC curve. Results The first day after infection, the serum levels of PCT in patients showed no significant difference between group A and group B （P 〉 0.05） ; but the serum PCT lev- els in group A decreased gradually on 5th, 5th and 7th days, while the serum PCT levels in group B patients were significantly increased, there was marked difference between group A and group B （P 〈 0.05 ）. the first, 3th, 5th ,7th days after infection, area under the ROC curve of the PCT was used to determine antimicrobial treatment failure were 0.447,0.716, 0.981,1. 000. The area under the ROC curve of PCT showing a significant differences between the 3th, 5th and 7thdays and first day （ P 〈0.05 ）. The duration of antibiotic therapy after 5 days, when PCT 3. 095μg/L was used as a cut point for antimicrobial treatment is invalid, sensitivity was 97.40% ,specificity was 91.04%. Conclusion The process of antimicrobial therapy in hospital-acquired respiratory tract infections, dynamic too-nitoring of PCT levels can be used as an effective indicator to optimizing antibiotic treatment.
出处
《放射免疫学杂志》
CAS
2012年第3期293-295,共3页
Journal of Radioimmanology
关键词
下呼吸道感染
降钙素原
抗生素
抗菌治疗
lower respiratory tract infections, procalcitonin, antibiotics, antimicrobial treatment
