血清降钙素原监测在ICU多重耐药菌感染抗生素治疗的应用

摘要

Objective To explore the effect and meaning of PCT monitoring in the antibiotics treatment against multi-resistant infect ions in 1CU. Methods A retrospective analysis was made on 104 adult patients with multi-resistant infections in ICU from March 2010 to March 2011. The patients were randomly divided into control group and PCT guiding group. The following indices were analysed, such as the use of antibiotics, the proportion of patients remaining in ICU In different treatment period and the level of inflammatory response. Results ①The antibiotic duration of PCT guiding group was shorter than the control [(6.83-1.25) d vs (9.23-1.87) d, P < 0.05], Meanwhile, the Kaplan-Meier curves showed that there was significant difference between two groups on the proportion of patients without antibiotics at different treatment time (P < 0.01);② Kaplan-Meier curves also showed that the proportion of patients remaining in ICU during different treatment period of PCT guiding group was significantly different from the control group (P < 0.01); ③The level of IL-6, CRP and white blood cell of PCT guiding group were lower than the control. Conclusion PCT can serve as a sensitive Indication to guide the antibiotics use against multi-resistant ICU Infections.%目的 探讨血清降钙素原(Procalcitonin,PCT)监测在指导ICU多重耐药菌感染抗生素治疗中的作用与意义.方法 对本院2010年3月～2011年3月确诊为ICU多重耐药菌感染的104例成年患者进行回顾性研究,将其随机分为对照组和PCT指导组,分析两组的抗生素使用情况、不同治疗时间段内ICU停留患者的比例以及炎性反应水平.结果 ①PCT指导组的抗生素使用天数少于对照组[(6.83±1.25)d vs(9.23±1.87)d,P<0.05],且Kaplan-Meier曲线表明:两组不同治疗时间内未使用抗生素患者的比例有差异(P<0.01);②Kaplan-Meier曲线表明:PCT指导组不同治疗时间段内ICU停留患者的比例与对照组有差异(P<0.01);③PCT指导组的IL-6、CRP以及白细胞计数低于对照组,且差异有统计学意义(P<0.05).结论 PCT的监测可作为指导ICU多重耐药菌感染抗生素治疗的重要指标,不仅减少了抗生素的使用,而且减少了患者的经济负担和医院床位的周转压力.