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目的分析探讨血清降钙素原(PCT)在老年社区获得性肺炎诊疗过程中的应用及临床效果。方法选取老年社区获得性肺炎患者328例,按照入院先后顺序分为实验组与对照组,每组均为164例。对照组按照常规治疗,实验组在加用血清PCT定期监测下诊断老年肺炎病原菌种类及调整治疗手段方法。两组病例以入院治疗后2周为该研究终点,比较患者的抗生素使用情况和临床预后。结果两组病人肺炎的主要致病病原体为细菌、病毒、衣原体、支体,各病例病原学资料分析比较,两者之间差异不具统计学意义(P>0.05);实验组中老年细菌性肺炎病人血清PCT明显高于其他肺炎患者血清水平(P<0.05)。实验组抗生素使用时间与种类均少于对照组,差异均有统计学意义(P<0.05)。实验组患者临床痊愈率、有效率高于对照组,但差异不具有统计学意义(P>0.05)。结论血清降钙素原是一个具有高度特异性的细菌感染性反应指标,受外界干扰影响小,对诊断老年肺炎患者病原体类型,指导临床合理使用抗生素,判断患者预后具有重要价值。
Objective To investigate the clinical application of serum procalcitonin (PCT) in the treatment of elderly community-acquired pneumonia. Methods A total of 328 elderly patients with community-acquired pneumonia were selected and divided into experimental group and control group according to the order of admission, with 164 cases in each group. The control group according to routine treatment, the experimental group plus regular serum PCT in the diagnosis of elderly pneumonia pathogenic bacteria and adjust the method of treatment. Two groups of patients were admitted to hospital 2 weeks after the end of the study to compare the patient’s antibiotic use and clinical prognosis. Results The main pathogens of pneumonia in the two groups were bacteria, virus, chlamydia and support, and the etiological data of each case were analyzed and compared. The difference between the two groups was not statistically significant (P> 0.05). In the experimental group, the incidence of bacterial pneumonia The serum PCT of patients was significantly higher than that of other pneumonia patients (P <0.05). The time and type of antibiotics in the experimental group were less than those in the control group, the differences were statistically significant (P <0.05). The clinical cure rate and effective rate of experimental group were higher than that of control group, but the difference was not statistically significant (P> 0.05). Conclusions Serum procalcitonin is a highly specific index of bacterial infection and is less affected by external disturbances. It is of great value in diagnosing the type of pathogen in elderly patients with pneumonia, guiding the rational use of antibiotics in clinic, and judging the prognosis of patients.