血清降钙素原在肝硬化腹腔积液患者抗菌治疗中的价值
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罗励

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R442.5R575.2

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Significance of procalcitonin test in guiding antimicrobial therapy in patients with liver cirrhosis ascites
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    摘要:

    目的探讨测定血清降钙素原(PCT)在治疗肝硬化腹腔积液患者中,指导临床抗菌药物使用的价值。方法选取某院2009年1月—2012年1月住院治疗的肝硬化腹腔积液患者100例,分为常规治疗组(给予常规综合治疗,20例)和抗感染治疗组(在常规治疗基础上加用头孢噻肟抗感染治疗,80例)。将抗感染治疗组分为抗感染治疗A组(PCT<0.5 ng/mL)、B组(0.5 ng/mL≤PCT≤2 ng/mL)和C组(PCT>2 ng/mL)。比较各组肝功能、凝血酶原活动度(PTA)结果及疗效。结果治疗后,抗感染治疗A组与常规治疗组比较,血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBIL)、PTA值差异无统计学意义(均P>0.05);抗感染治疗B、C组与抗感染治疗A组、常规治疗组比较,ALT、AST及TBIL值显著降低, PTA值显著升高(均P<0.05)。常规治疗组及抗感染治疗A、B、C组患者治疗后综合疗效的总有效率分别为60.00%(12/20)、66.67%(18/27)、87.50%(28/32)、90.48%(19/21),差异有统计学意义(χ2=9.04,P=0.03),抗感染治疗B、C组综合疗效的总有效率显著增高。结论参考PCT水平,对判断肝硬化腹腔积液患者是否并发细菌性腹膜炎,并决定是否行抗感染治疗,具有一定价值。

    Abstract:

    ObjectiveTo evaluate the significance of procalcitonin(PCT) test in guiding antimicrobial therapy in patients with liver cirrhosis ascites.MethodsOne hundred patients with liver cirrhosis ascites in a hospital between January 2009 and January 2012 were randomly divided into routine therapy group(routine comprehensive therapy, n=20) and antiinfective therapy group(cefotaxime therapy in addition to routine therapy, n=80),then antiinfective group was subdivided into antiinfective group A(PCT<0.5 ng/mL), antiinfective group B(0.5 ng/mL≤PCT≤2 ng/mL)and antiinfective group C(PCT>2 ng/mL).Liver function, prothrombin activity (PTA)and therapeutic efficacy between three groups were compared.ResultsAfter therapy, the difference in serum alanine transaminase(ALT), aspartic transaminase(AST),total bilirubin(TBIL),and PTA between antiinfective group A and routine therapy group were not significantly different(all P>0.05);compared with antiinfective group A and routine therapy group, ALT,AST and TBIL in antiinfective group B and C decreased significantly, while PTA increased significantly (all P<0.05). The total efficacy rate in routine therapy group, antiinfective group A, B and C was 60.00%(12/20),66.67%(18/27),87.50%(28/32),and 90.48%(19/21),respectively(χ2=9.04,P=0.03), the total efficacy rate in antiinfective group B and C increased significantly.ConclusionDetection of PCT is benefit to judge the development of bacterial peritonitis in patients with liver cirrhosis ascites and guide rational use of antimicrobial agents.

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罗励,钟吉文,赵灵,等.血清降钙素原在肝硬化腹腔积液患者抗菌治疗中的价值[J]. 中国感染控制杂志,2013,12(4):281-284. DOI:10.3969/j. issn.1671-9638.2013.
LUO Li, ZHONG Jiwen, ZHAO Ling, et al. Significance of procalcitonin test in guiding antimicrobial therapy in patients with liver cirrhosis ascites[J]. Chin J Infect Control, 2013,12(4):281-284. DOI:10.3969/j. issn.1671-9638.2013.

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  • 收稿日期:2012-07-28
  • 最后修改日期:2012-10-22
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  • 在线发布日期: 2013-07-30
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