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目的探讨降钙素原(PCT)及D-二聚体(D-D)水平与慢性阻塞性肺疾病急性加重期(AECOPD)病因的相关性及对初始抗生素治疗的指导作用。方法将AECOPD患者86例随机分为观察组和对照组各43例,观察组根据血清PCT、D-D水平指导用药,对照组患者根据医师临床经验予以抗生素治疗。比较观察组不同病原菌感染所致PCT、D-D水平。对比2组抗生素使用率和抗生素使用时间。结果细菌感染引起的AECOPD患者PCT和D-D均增高,病毒性感染引起的AECOPD患者仅D-D水平增高。观察组抗生素使用率明显低于对照组,抗生素使用时间明显短于对照组,差异均有统计学意义(P<0.05)。结论对AECOPD患者行PCT、D-D检测有助于评估是否细菌感染,进而有利于对初始抗生素指导用药。
Objective To investigate the correlation between the levels of procalcitonin (PCT) and D-dimer (D-D) and the etiology of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to provide guidance for the initial antibiotic therapy. Methods 86 patients with AECOPD were randomly divided into observation group and control group, with 43 cases in each group. The observation group was given medication according to serum PCT and D-D levels. Patients in the control group were treated with antibiotics based on clinical experience. The levels of PCT and D-D in different groups of pathogens were compared. Compare the two groups of antibiotics usage and antibiotic use time. Results The bacterial infection caused AECOPD patients with PCT and D-D were increased, viral infection caused by AECOPD only elevated D-D levels. The use of antibiotics in the observation group was significantly lower than that in the control group, antibiotic use time was significantly shorter than the control group, the difference was statistically significant (P <0.05). Conclusion AECOPD patients with PCT, D-D test can help to assess whether the bacterial infection, and thus help guide the initial antibiotic medication.