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目的 :观察血清降钙素原(PCT)在社区获得性肺炎患者诊治过程中的变化,根据血清PCT水平指导抗生素选择,分析PCT在非重症社区获得性肺炎治疗过程中的临床价值。方法 :选取2013年12月~2014年12月来我院门诊和病房就诊的非重症社区获得性肺炎患者120例,随机分为观察组和对照组,观察组按照PCT水平指导是否用抗生素,经过抗生素治疗后的3~5天再评估PCT水平,当PCT值下降超过90%停用抗生素;对照组根据用药指导判断抗生素选择,治疗过程中测定患者的CRP、WBC及体温等,将患者临床治疗效果按照治愈、显效、好转或无效进行评估。结果 :两组肺炎患者治疗有效率分别为91.7%和93.3%,治疗的有效率不存在明显差异,但是根据PCT进行选药的观察组,抗生素使用天数和治疗费用要明显低于对照组,差异有显著性。结论 :监测血清PCT在非重症社区获得性肺炎的临床治疗中有指导价值,可降低抗生素的使用天数,减少患者医疗负担,对临床用药有参考意义。
OBJECTIVE: To observe the changes of serum procalcitonin (PCT) in the diagnosis and treatment of community-acquired pneumonia and to guide the selection of antibiotics according to the level of serum PCT. The clinical value of PCT in the treatment of non-severe community-acquired pneumonia was analyzed. Methods: One hundred and twenty non-critical community-acquired pneumonia patients from our hospital from December 2013 to December 2014 were randomly divided into observation group and control group. The observation group was instructed whether to use antibiotics according to the PCT level. PCT levels were reassessed 3 to 5 days after antibiotic treatment, antibiotics were discontinued when the PCT value dropped by more than 90%, control groups were given antibiotic selection based on medication guidelines, CRP, WBC and body temperature were measured during treatment, The effect is evaluated in terms of cure, improvement, improvement or ineffectiveness. Results: The effective rates of two groups of patients with pneumonia were 91.7% and 93.3%, respectively, and there was no significant difference in the effective rate of treatment. However, in the observation group selected by PCT, the days of antibiotic use and the cost of treatment were significantly lower than those of the control group Significant. Conclusion: Monitoring serum PCT has guiding value in the clinical treatment of non-severe community-acquired pneumonia, which can reduce the days of antibiotics and reduce the medical burden on patients, which is of clinical significance.