摘要
目的比较不同PCT界值下慢性阻塞性肺疾病急性加重期抗生素使用的差异,寻找合理的停用抗生素的PCT界值。方法选取2017年3月-2018年6月至我科住院的AECOPD患者90例,分为3组,试验一、二组分别在PCT小于0.25ng/ml和小于0.15ng/ml停用抗生素。另设立对照组,改变不监测PCT,仅以CRP,WBC水平结合临床决定抗生素疗程。观察在使用抗生素的第1,5,7,9,11,13,…d的PCT、CRP、WBC值的变化,比较各组间数据的差异。并观察其30d内的再次入院的情况。结果对照组停用抗生素时的WBC值为(6.13±2.23)×109/L,试验一组停用抗生素时的WBC值为(7.50±1.78)×109/L,与对照组存在显著性差异(P=0.009)。试验二组停用抗生素时的WBC值为(6.49±1.85)×109/L,与对照组(P=0.479)及试验一组(P=0.051)均无显著性差异。对照组停用抗生素时的CRP值为(24.23±11.39)mg/L;试验一组停用抗生素时的CRP值为(22.14±11.32)mg/L;试验二组停用抗生素时的CRP值为(19.13±8.89)mg/L。各组间无显著性差别(P=0.18)。对照组抗生素使用为(15.9±2.47)d,试验一组抗生素使用为(10.03±2.95)d,与对照组有显著性差异(P=0.00)。试验二组抗生素使用为(11.30±2.25)d,与对照组有显著性差异(P=0.00)。治疗组缓解率为88%,试验一组缓解率为82%,试验二组还缓解率为85%,各组缓解率无显著性差异(P=0.919)。30d随访观察期内,对照组1例复发,复发率3.33%;试验一组2例复发,复发率6.67%;试验二组2例复发,复发率6.67%。各组间无显著性差异(P=0.809)。结论在慢阻肺急性加重期治疗中,对以PCT 0.25ng/ml作为停用抗生素的界值较以PCT 0.15ng/ml及血白细胞作为界值抗生素使用时间更短,治疗缓解率无区别,且不影响30d内再次入院率。
Objective To find a better PCT cut-off of antibiotics ceasation,though comparing the differnence of different PCT cut-off in antibiotics use of patients with AECOPD.Methods 90 AECOPD cases admitted in our hospital were selected from Mar.2017 to Jun.2018,divided into three groups.In the first and the second group,antibiotics use were ceased when PCT value was below 0.25,0.15ng/ml respectively.Among the third group,we made the decision of antibiotics duaration just by CRP,WBC level and clinical conditon,not minutoring PCT value.The variation of PCT,CRP,WBC on day1,5,7,9,11,13……level were observed and compared.Moreover,readmission in 30 days were observed.Results White blood cell count when stopping using antibiotics in control group was(6.13±2.23)×109/L,while the experiment group one was(6.13±2.23)×109/L.There was a significant difference between the two groups(P=0.009).The experiment group two white blood cell count when stopping using antibiotics was(6.49±1.85)×109/L,without significant difference compared to the control group(P=0.479)and experiment group one(P=0.051).C-reactive protein value when stopping using the antibiotics were(24.23±11.39)mg/l,(22.14±11.32)mg/L,(19.13±8.89)mg/L repectivly in control group,experiment group one and two.There was no significant difference among the three groups(P=0.18).The antibiotics duration were(15.9±2.47)d,(10.03±2.95)d,(11.30±2.25)d respectively in the control group,experiment group one and two.There were significant difference between the experiment group and the control group(P1=0.00 P2=0.00).Remission rate of treatment were 88%,82%,85%respectively in control group,experiment group one and two,with no signifcant difference among the three groups(P=0.919).During the 30d follow-up observation,there was 1,2,2 case recrudesce respectively in control group,experiment one and two,with no significant difference among the three groups(P=0.809).Conclusion In the treatment of acute exacerbation of chronic obstructive pulmonary disease,the antibiotics duration of u
作者
方晓琳
蔡得汉
汪俊
郭韶梅
王红鸾
FANG Xiaolin;CAI Dehan;WANG Hongluan(DepartmetⅡof Respiratory and Critical Care,Jiangxi Provincial Peopie's Hospital,Nanchang,330006,China.)
出处
《江西医药》
CAS
2020年第6期658-660,共3页
Jiangxi Medical Journal
关键词
降钙素原
慢阻肺急性加重期
抗生素使用
Procalcitonin
Acute exacerbation of chronic obstructive pulmonary disease
Antibiotics duration
