摘要
目的探讨采用血清降钙素原对慢性阻塞性肺疾病(COPD)急性加重期患者抗菌药物管理的指导效果。方法100例COPD急性加重期患者,随机分为对照组与实验组,各50例。对照组根据患者不同临床症状进行相应的抗菌治疗,依据血常规以及痰培养结果等来观察疗效以及制定治疗方式,实验组治疗方法与对照组相同,但依据患者的血清降钙素原水平来观察疗效并调整下一步是否使用抗菌药物的治疗方式。比较两组疗效、氧化应激指标、抗生素使用情况、住院期间死亡率、远期疗效。结果实验组治疗总有效率为92.00%,高于对照组的74.00%,差异有统计学意义(P<0.05)。缓解期第1天两组总抗氧化能力(T-AOC)、丙二醛(MDA)、超氧化物歧化酶(SOD)均较加重期第1天改善,且实验组均优于对照组,差异有统计学意义(P<0.05)。实验组抗生素使用率66.00%低于对照组的94.00%,差异有统计学意义(P<0.05)。实验组住院期间死亡率6.00%低于对照组的20.00%,差异有统计学意义(P<0.05)。治疗结束后6个月内,实验组再次进入COPD急性加重期发生率28.00%、急性发作次数(1.46±0.22)次、死亡率2.00%均低于对照组的50.00%、(2.23±0.17)次、16.00%,差异均有统计学意义(P<0.05)。结论根据血清降钙素原水平指导医师对COPD急性加重期患者使用抗菌药物具有更高的指导意义,在临床上患者应激状态得以明显改善,有效降低了死亡率,对远期疗效也有较大帮助,值得临床推广。
Objective To discuss the guiding effect of serum procalcitonin on the management of antibacterial drugs in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 100 patients with acute exacerbation of COPD were randomly divided into control group and experimental group,with 50 cases in each group.In the control group,all patients received corresponding antibacterial treatments according to the different clinical symptoms of the patients,and the treatment was formulated according to blood routine and sputum culture results.In the experimental group,the treatment method was the same as that of the control group,but the antibacterial treatment was formulated according to the patient’s serum procalcitonin level.The clinical efficacy,oxidative stress index,antibiotic use,mortality during hospitalization,long-term efficacy were compared between the two groups.Results The total effective rate of the experimental group was 92.00%,which was higher than 74.00%of the control group,and the difference was statistically significant(P<0.05).On the first day of remission,the total antioxidant capacity(T-AOC),malondialdehyde(MDA)and superoxide dismutase(SOD)of the two groups were improved compared to the first day of exacerbation,and the experimental group was better than the control group.All the difference was statistically significant(P<0.05).The antibiotic use rate 66.00%of the experimental group was lower than 94.00%of the control group,and the difference was statistically significant(P<0.05).The mortality during hospitalization 6.00%of the experimental group was lower than 20.00%of the control group,and the difference was statistically significant(P<0.05).Within 6 months after treatment,the incidence of acute exacerbation of COPD again 28.00%,frequency of acute attacks(1.46±0.22)times and mortality 2.00%of the experimental group were lower than 50.00%,(2.23±0.17)times,and 16.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion It is of great significance for doctors to guide the use of antibiotics in patients with acute exacerbation of COPD according to the level of serum procalcitonin,which can significantly improve the stress state of patients,effectively reduce mortality,and is also of great help to long-term efficacy It is worthy of clinical promotion.
作者
刘文建
LIU Wen-jian(Qihe County People’s Hospital,Dezhou 251100,China)
出处
《中国现代药物应用》
2021年第9期229-231,共3页
Chinese Journal of Modern Drug Application
关键词
血清降钙素原
慢性阻塞性肺疾病
抗菌治疗
Serum procalcitonin
Chronic obstructive pulmonary disease
Antibacterial treatment
