摘要
目的探讨测定血清降钙素原(PCT)在治疗肝硬化腹腔积液患者中,指导临床抗菌药物使用的价值。方法选取某院2009年1月—2012年1月住院治疗的肝硬化腹腔积液患者100例,分为常规治疗组(给予常规综合治疗,20例)和抗感染治疗组(在常规治疗基础上加用头孢噻肟抗感染治疗,80例)。将抗感染治疗组分为抗感染治疗A组(PCT<0.5 ng/mL)、B组(0.5 ng/mL≤PCT≤2 ng/mL)和C组(PCT>2 ng/mL)。比较各组肝功能、凝血酶原活动度(PTA)结果及疗效。结果治疗后,抗感染治疗A组与常规治疗组比较,血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBIL)、PTA值差异无统计学意义(均P>0.05);抗感染治疗B、C组与抗感染治疗A组、常规治疗组比较,ALT、AST及TBIL值显著降低,PTA值显著升高(均P<0.05)。常规治疗组及抗感染治疗A、B、C组患者治疗后综合疗效的总有效率分别为60.00%(12/20)、66.67%(18/27)、87.50%(28/32)、90.48%(19/21),差异有统计学意义(χ2=9.04,P=0.03),抗感染治疗B、C组综合疗效的总有效率显著增高。结论参考PCT水平,对判断肝硬化腹腔积液患者是否并发细菌性腹膜炎,并决定是否行抗感染治疗,具有一定价值。
Objective To evaluate the significance of procalcitonin（PCT） test in guiding antimicrobial therapy in patients with liver cirrhosis ascites. Methods One hundred patients with liver cirrhosis ascites in a hospital between January 2009 and January 2012 were randomly divided into routine therapy group（routine comprehensive therapy, n = 20） and anti-infective therapy group（cefotaxime therapy in addition to routine therapy, n = 80）, then anti-infec- tive group Was subdivided into anti-infective group A（PCT〈0. 5 ng/mL）, anti-infective group B（0. 5 ng/mL≤PCT≤2 ng/mL）and anti-infective group C（PCT〉2 ng/mL）. Liver function, prothrombin activity （PTA）and therapeu- tic efficacy between three groups were compared. Results After therapy, the difference in serum alanine transami- nase（ALT）, aspartic transaminase（AST）,total bilirubin（TBIL）,and PTA between anti-infective group A and rou- tine therapy group were not significantly different（all P〈0. 05） ;compared with anti-infective group A and routine therapy group, ALT,AST and TBIL in anti-infective group B and C decreased significantly, while PTA increased significantly （all P〈0. 05）. The total efficacy rate in routine therapy group, anti-infective group A, B and C was 60. 00% （12/20） ,66. 67% （18/27） ,87.50% （28/32）, and 90. 48% （19/21）, respectively（x2= 9. 04,P = 0. 03）, the total efficacy rate in anti-infective group B and C increased significantly. Conclusion Detection of PCT is benefit to judge the development of bacterial peritonitis in patients with liver cirrhosis ascites and guide rational use of antimi- crobial agents.
出处
《中国感染控制杂志》
CAS
2013年第4期281-284,共4页
Chinese Journal of Infection Control
关键词
降钙素原
肝硬化
腹腔积液
抗感染治疗
procalcitonin
liver cirrhosis
ascites
anti-infective therapy
