降钙素原在判断老年医院获得性肺炎致病菌耐药性的应用价值

摘要

Objective To investigate the difference and application value of serum procalcitonin (PCT)in drugresistant bacteria and sensitive bacteria in hospital acquired pneumonia(HAP) in the elderly patients.Methods 92 cases of elderly patients with HAP were selected.According to the results of sputum culture,the results were divided into three groups:the extensively drug resistant strains,the multi-drug resistant strains and the susceptible strains.3 groups of serum PCT,white blood cell (WBC) and high sensitivity C reactive protein (CRP) levels were statistically analyzed.Results The serum levels of PCT in the elderly patients with HAP in the extensively drug resistant strains and the multi-drug resistant strains were significantly higher than those in the susceptible strains (P ＜ 0.05).The serum PCT level of the extensively drug resistant strains was higher than that of the multi-drug resistant strains (P ＜ 0.05).There was significant difference of CRP between the extensively drug resistant strains,multi-drug resistant strains and sensitive strains group (P ＜ 0.05) However,there was no significant difference of CRP between the extensively drug resistant strains and multi-drug resistant strains (P ＞0.05).There was no significant difference among the three groups's of WBC (P ＞0.05).Conclusion Serum PCT is better than WBC and CRP in judging the pathogens of HAP in the elderly patients,which can help to guide the adjustment of antibiotic use and reduce the generation of drug-resistant bacteria.%目的 探讨血清降钙素原(procalcitonin,PCT)在老年医院获得性肺炎(hospital acquired pnemonia,HAP)中耐药菌和敏感菌中的差异及应用价值.方法 选取92例老年医院获得性肺炎患者,按痰培养结果分为广泛耐药菌株组、多重耐药菌株组、敏感菌株组,检测3组血清PCT、白细胞及超敏C反应蛋白水平,进行统计学分析.结果 老年医院获得性肺炎广泛耐药菌株组和多重耐药菌株组血清PCT高于敏感菌株组(P＜0.05),广泛耐药菌株组血清PCT高于多重耐药菌株组(P＜0.05).广泛耐药菌株组和多重耐药菌株组超敏C反应蛋白水平与敏感菌株组比较差异有统计学意义(P＜0.05),而广泛药菌株组和多重菌株组之间超敏C反应蛋白水平差异无统计学意义(P＞0.05).三组之间白细胞水平差异均无统计学意义(P＞0.05).结论 血清降钙素原对于判断老年医院获得性肺炎致病菌耐药性优于白细胞、超敏C反应蛋白,对指导调整抗生素使用及减少耐药菌产生有一定意义.