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目的探讨血清降钙素原(PCT)检测在指导成人非重症社区获得性肺炎抗菌治疗的价值。方法将65例成人非重症社区获得性肺炎患者随机分为PCT指导组31例和对照组34例。PCT指导组根据PCT水平决定是否停用抗生素,当PCT<0.25ng/ml时考虑停用抗生素,对照组按临床路径标准,根据胸部CT或胸部X线片、症状、血常规等决定是否停用抗生素。对比2组抗生素疗程及出院后30d再住院率。结果 PCT指导组抗生素停用疗程短于对照组,疗程<10d的比例(93.5%)高于对照组(11.8%);疗程≥10d的比例(6.5%)低于对照组(88.2%),差异均有统计学意义(P<0.01)。2组出院后30d内均无再住院患者。结论 PCT水平检测指导成人非重症社区获得性肺炎的抗菌治疗,缩短了抗生素疗程,减少耐药发生,值得临床推广应用。
Objective To investigate the value of serum procalcitonin (PCT) detection in guiding adult patients with non-severe community-acquired pneumonia. Methods Sixty-five adult patients with non-severe community-acquired pneumonia were randomly divided into three groups: 31 cases in the PCT group and 34 cases in the control group. The PCT group decided to discontinue antibiotics according to the PCT level. Antibiotics should be discontinued when PCT <0.25 ng / ml. The control group was to decide whether to stop using clinical path criteria, chest CT or chest X-ray, symptom, blood routine, etc. antibiotic. Compare the two groups of antibiotics treatment and hospitalization 30d after discharge rate. Results The antibiotic withdrawal course in the PCT group was shorter than that in the control group (93.5%) during the course of treatment (93.5%) and lower than that of the control group (6.5% vs 10.0%, 88.2% All were statistically significant (P <0.01). 2 groups were no longer hospitalized within 30 days after discharge. Conclusion The PCT level test can guide the antibacterial treatment of non-severe community-acquired pneumonia in adults, shorten the course of antibiotics and reduce the occurrence of drug resistance, which is worthy of clinical application.