摘要
目的探讨血清降钙素原(PCT)测定在下呼吸道感染鉴别诊断及治疗中的应用价值。方法将200例下呼吸道感染患者按临床症状、胸部X线检查、实验室检查(痰培养、血清学检测、抗原检测、分子生物学检测)等结果分为细菌感染组、病毒感染组、支原体和衣原体感染组,同时选取健康体检者50名作为正常对照组,比较各组PCT水平;再将细菌感染组按患者自愿原则分成对照组和治疗组,对照组按照抗菌药物使用指南进行常规抗菌药物治疗,治疗组采用PCT水平监测其抗菌药物使用情况,比较2个组抗菌药物使用率及使用天数、患者住院时间及住院费用等。结果细菌感染组、支原体和衣原体感染组血清PCT水平显著高于病毒感染组和正常对照组(P<0.05);细菌感染组与支原体和衣原体感染组比较,差异亦有统计学意义(P<0.05);病毒感染组与正常对照组比较,差异无统计学意义(P>0.05)。细菌感染组、病毒感染组、支原体和衣原体感染组PCT检测阳性率分别为97.6%、17.1%、17.9%。治疗组、对照组抗菌药物平均使用率分别为45.75%和64.15%,抗菌药物使用天数分别为6.5±1.6和(10.1±2.2)d,患者住院天数分别为9.4±2.8和(12.8±4.5)d,患者住院费用分别为5 862.5±98.6和(7 420.5±115.4)元。以上4个指标2个组间差异均有统计学意义(P<0.05)。结论 PCT检测可以辅助临床鉴别下呼吸道感染类型,监测PCT水平对下呼吸道细菌感染患者的抗菌药物治疗具有指导意义。
Objective To investigate the significance of serum procalcitonin（PCT） determination in the diagnosis and treatment of lower respiratory tract infection. Methods According to clinical symptoms,chest X-ray results and laboratory determination（sputum culture,serological detection,antigen detection and molecular biological detection） results,200 patients with lower respiratory tract infection were classifi ed into bacterial infection,viral infection and mycoplasma and chlamydia infection groups,and their PCT levels were compared with those of 50 healthy subjects（healthy control group）. According to the voluntary principles,the bacterial infection group was sub-classifi ed into control group and treatment group. Control group was treated according to antibiotics usage guidelines for regular treatment,and treatment group was treated with antibiotics by monitoring PCT levels. The antibiotic usage rates,antibiotic usage days,the length of inhospital,inhospitalization expenses,and so on were compared between the 2 groups. Results PCT levels in bacterial infection group and mycoplasma and chlamydia infection group were signifi cantly higher than those in viral infection group and healthy control group（P〈0.05）. PCT levels between bacterial infection group and mycoplasma and chlamydia infection group had statistical signifi cance（P〈0.05）,and those between viral infection group and healthy control group had no statistical signifi cance（P〉0.05）. PCT positive determination rates were 97.6% in bacterial infection group,17.1% in viral infection group and 17.9% in mycoplasma and chlamydia infection group. The antibiotic usage rates in treatment group and control group were 45.75% and 64.15%,respectively. The antibiotic usage days were 6.5±1.6 and（10.1±2.2）d. The lengths of inhospital were 9.4±2.8 and（12.8±4.5）d. Inhospitalization expenses were 5 862.5±98.6 and（7 420.5±115.4）CNY. The above statistics indices between the 2 groups had statistical signifi cance（P〈0.05）. Conclusions
出处
《检验医学》
CAS
2016年第5期379-382,共4页
Laboratory Medicine
关键词
降钙素原
下呼吸道感染
抗菌药物
Procalcitonin
Lower respiratory tract infection
Antibiotics
