降钙素原缩短脓毒症患者抗感染疗程的有效性和安全性临床观察

摘要

Objective To explore the value of serum procalcitonin (PCT) in reducing anti-infection therapies in patients with sepsis.Method Seventy-eight patients with high suspected or confirmed sepsis from September 2015 to March 2016 were randomly assigned into two groups: PCT-guided group (n=41) and control group (n=37). Patients in control group received antibiotics according to clinical symptoms, current Guidelines, while patients in PCT-guided group received antibiotics according to serum PCT levels. The outcomes of days of antibiotics use, 28 days of mortality, length of ICU stay, length of mechanical ventilation, rates of Multi drug resistant bacteria (MDR) and exacerbation within 28 days were observed and compared between two groups.Result PCT-guided group were associated with a significant difference in days of antibiotics use (7.22 days vs 9.57 days, P=0.009), length of ICU stay (10.37 days vs 13.0 days,P=0.028) when compared with that of control group. No differences were observed in outcomes of 28 days of mortality, length of mechanical ventilation, rates of Multi drug resistant bacteria (MDR) and exacerbation within 28 days ( P>0.05).Conclusion Serum PCT level could be used to reduce the anti-infection therapies in patients with sepsis and resulted in a shorter length of ICU stays, without affecting other important clinical outcomes.%目的 探讨降钙素原(procalcitonin,PCT)指导ICU脓毒症患者停用抗感染药物的有效性和安全性.方法 选取2015年9月至2016年3月本院ICU收治的脓毒症患者共78例,随机分为PCT组(n=41)和对照组(n=37).对照组和PCT组分别由临床医师和PCT浓度来决定抗菌药物的使用.结果 与对照组相比,PCT组得抗生素使用天数(7.22天vs 9.57天,P=0.009)、ICU住院天数(10.37天vs 13.0天,P=0.028)均显著缩短.两组28天病死率、机械通气时间、感染复发情况以及多重耐药菌发生率等方面差异无显著性(P>0.05).结论 脓毒症患者在PCT指导下停用抗菌药物,可减少抗菌药物暴露及ICU住院时间,且不影响其他临床指标.