[1]谢广超,李琼,蔡静月,等.应用降钙素原动态检测指标指导脑出血发热患者合理使用抗菌药物的价值[J].卒中与神经疾病杂志,2016,23(06):403-406.[doi:10.3969/j.issn.1007-0478.2016.06.005]
　Xie Guangchao,Li Qiong,Cai Jingyue,et al.The value of procalcitonin dynamic detection guiding the rational use of antimicrobial agents in patients with cerebral hemohrrhage fever[J].Stroke and Nervous Diseases,2016,23(06):403-406.[doi:10.3969/j.issn.1007-0478.2016.06.005]
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应用降钙素原动态检测指标指导脑出血发热患者合理使用抗菌药物的价值()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第23卷
期数:
2016年06期
页码:
403-406
栏目:
论 著
出版日期:
2016-12-30

文章信息/Info

Title:
The value of procalcitonin dynamic detection guiding the rational use of antimicrobial agents in patients with cerebral hemohrrhage fever
文章编号:
1007-0478(2016)06-0403-04
作者:
谢广超; 李琼; 蔡静月; 蔡杰; 梁宇航
524037 广东省湛江中心人民医院临床药学室
Author(s):
Xie Guangchao; Li Qiong; Cai Jingyue; et al.
Department of Clinical Pharmaceutics,Zhanjiang Central People's Hospital,Zhanjiang 524037
关键词:
降钙素原 脑出血 发热 抗菌药物
Keywords:
Procalcitonin Cerebral hemorrhage Fever Antimicrobial agents
分类号:
R743.34
DOI:
10.3969/j.issn.1007-0478.2016.06.005
文献标志码:
A
摘要:
目的 研究降钙素原(PCT)动态检测指标指导脑出血发热患者合理使用抗菌药物的价值。方法 入选2013年5月～2015年4月湛江中心人民医院收治的240例脑出血伴发热患者,根据抽签法分为观察组和对照组,各120例; 观察组患者需根据PCT动态值确定抗菌药的使用,对照组不参考PCT值,根据临床情况给予抗菌药治疗; 记录观察组患者在不同时间点PCT水平情况,比较2组患者的菌群、抗菌药物使用、住院及转归情况。结果 抗感染治疗后观察组患者在1、3、5、7、30 d的PCT水平显著低于治疗前[(18.23±2.01)μg/L、(14.34±1.87)μg/L、(7.24±1.12)μg/L、(3.43±0.34)μg/L、(0.87±0.04)μg/L 比(25.04±2.32)μg/L],差异均有统计学意义(P<0.05)。2组患者的病原菌种类比较差异无统计学意义(P>0.05)。观察组患者的抗菌药物使用率显著低于对照组[56.67%(68/120)比86.67%(104/120)],使用时间显著短于对照组[(9.32±1.23)d比(13.38±1.31)d],使用费用显著少于对照组[(2 573.21±142.15)元 比(4 632.15±264.77)元],差异均有统计学意义(P<0.05)。观察组患者的住院时间显著少于对照组[(9.89±1.54)d比(11.38±1.31)d],差异有统计学意义(P<0.05)。临床治愈率比较无统计学意义[90.0%(108/120)比86.67%(104/120)](P>0.05)。结论 应用PCT动态监测指标指导脑出血发热患者使用抗菌药物,能减少抗菌药物的费用,降低抗菌药物的使用率,能在一定程度上避免抗菌药的过度使用,缓解了抗菌药带来的耐药压力。
Abstract:
ObjectiveTo study the value of procalcitonin(PCT)dynamic detection guiding the rational use of antimicrobial agents in patients with cerebral hemorrhage fever.Methods 240 patients with cerebral hemorrhage and fever admitted in zhanjiang central people's hospital from May 2013 to April 2015, according tothe draw method the patients was divided into observation group and control group, 120 patients in each group. The use of antimicrobials in the observation group based on PCT dynamic value,then the control group based on the clinical situation. Record the PCT levels in observation group at different time,and compare bacteria,antimicrobial drug use and the outcome,length of stay of the two groups.Results After anti-infection treatment for 1 d, 3 d, 5 d, 7 d, 30 d, the PCT levels of patients in the observation group were significantly lower than before [(18.23±2.01)μg/L,(14.34±1.87)μg/L,(7.24±1.12)μg/L,(3.43±0.34)μg/L,(0.87±0.04)μg/L VS(25.04±2.32)μg/L], these differences had statistical significance(P<0.05). Bacteria of pathogenic had no statistical significance between two groups(P>0.05). Antimicrobial drug use in observation group was less than the control group [56.67%(68/120)VS 86.67%(104/120)], using time was shorter than the control group [(9.32±1.23)d VS(13.38±1.31)d], the cost of drugs was less than the control group [(2 573.21±142.15)yuan VS(4 632.15±264.77)yuan], length of stay was less than the control group [(9.89±1.54)d VS(11.38±1.31)d], and all the differences had statistical significance(P<0.05). Clinical cure rate had no statistical significance between two groups[90.0%(108/120)VS 86.67%(104/120)](P>0.05).Conclusion PCT dynamic monitoring guiding patients with cerebral hemorrhage fever using antibacterial drugs can decrease the cost of the antibacterial drugs, reduce the usage of antibiotics, avoid the overuse of antimicrobials to some extent,relieve the pressure resistance of antimicrobials.

参考文献/References:

[1] Santini D,Tonini G.Treatment of advanced Renal-Cell carcinoma[J].N Engl J Med,2016,374(9):888-889.
[2] 李艳,李娅,王应平,等.脑出血危重患者多药耐药鲍氏不动杆菌感染与耐药性研究[J].中华医院感染学杂志,2016,26(1):65-67.
[3] Motzer RJ,Escudier B,Choueiri TK.Treatment of advanced Renal-Cell carcinoma[J].N Engl J Med,2016,374(9):889-890.
[4] 李蓓,霍敏琴,李仲廷,等.血清降钙素原在 AECOPD 中抗感染治疗的指导意义[J].重庆医学,2015,22(22):3111-3112.
[5] 卫生部疾病预防控制局.中国脑血管病防治指南[M].北京:人民卫生出版社,2007:62-63.
[6] 徐爱蕾,王为.降钙素原检测方法学和临床意义的研究进展[J].临床军医杂志,2012,40(1):242-244.
[7] Brott T,Adams HP,Olinger CP,et al.Measurements of acute cerebral infarction: a clinical examination scale[J].Stroke,1989,20(7):864-870.
[8] 张谨超,崔朝勃,高文金,等.老年心力衰竭合并肺部感染患者血清降钙素原测定的临床意义[J].中华老年心脑血管病杂志,2014,26(10):1035-1037.
[9] 刘辰龙,刘洁.中成药联合抗菌药物治疗肺癌化疗患者肺部感染的临床疗效观察[J].中国生化药物杂志,2015,84(6):124-126.
[10] Cavalcante R,Sotomi Y,Onuma Y.Polymer-free Drug-Coated Coronary Stents[J].N Engl J Med,2016,374(9):892.
[11] Chandrasekhar J,Mehran R.Polymer-free Drug-Coated Coronary Stents[J].N Engl J Med,2016,374(9):891-892.
[12] 郁可,刘媛,陈琳,等.血清降钙素原对急性脑卒中患者发热原因的鉴别价值[J].中国实用神经疾病杂志,2013,16(4):12-14.
[13] Maruna P,Nedelnikova K,Gurlieh R.Psiology and genetiesof Proealeitonin[J].Physiol Res,2000,49.
[14] WhangK,Steinwad PM,White JC,et al.Serumealeitonin Preeursorsi Se Psisandsystemieinflanunation[J].Clin Endocrinol Metab,2008.
[15] 雷振东,邱泽亮,雷李美,等.降钙素原水平对老年慢性阻塞性肺疾病急性加重期选用抗菌药物的指导价值[J].中国全科医学,2014,23(35):4245-4247.

备注/Memo

备注/Memo:
基金项目:湛江市科技计划项目(编号为2015B01141)
更新日期/Last Update: 2016-12-20