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PCT在新生儿呼吸机相关性肺炎抗生素治疗中的应用

, PP. 341-344

Keywords: 降钙素原,新生儿,呼吸机相关性肺炎,抗菌药物

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Abstract:

目的探讨血清降钙素原(PCT)检测在新生儿呼吸机相关性肺炎(VAP)治疗中对抗菌药物使用的指导意义。方法选取56例新生儿呼吸机相关性肺炎患儿随机分成两组PCT组30例,对照组26例,PCT组根据血清PCT检测水平来判断抗生素的使用;常规组根据患者血CRP、X线胸片、痰培养以及其他实验室检查判断抗生素的使用。观察两组新生儿的抗生素使用时间、使用率、住院时间、死亡率等。结果PCT组的抗生素使用时间为(9.5±1.9)d,对照组为(11.8±2.1)d,两组差异有统计学意义(t=4.3,P=0.0001);两组的抗生素使用率、住院时间、死亡率及再发率差异无统计学意义(P>0.05)。结论PCT可有效指导新生儿呼吸机相关性肺炎的抗生素治疗,明显缩短抗生素使用时间,减少抗生素暴露。

References

[1]  Fischer JE,Ramser M,Fanconi S.Use of antibiotics intens-ive care and potential savings [J].Intensive Care Med,2000,26(6):959-966.
[2]  Brunlhorst F M,AI-Nawas B,Krunmmenauer F,et al.Procalcitonin,C reactive protein and APACHE Ⅱ score for risk evaluation in patients with severe pneumonia [J].Clin Microbiol Infect,2002,8(2):93-100.
[3]  Bouadma L,Luyt CE,Tubach F,et al.Use of procalcitonin to reduce patients’exposure to antibioties in intensive care units(PRORATA trial):a multicentre randomised controlled trial [J].Lancet,2010,375:463-474.
[4]  Medun GU.Diagnosis of ventilator-associated pneumonia [J].Infect Dis Clin North Am,2003,7(2):295-329.
[5]  Schuetz P, Batschw Aroff M, Dusemund F, et al. Effetiveness of a procalcitonin algorithm to guide antibiotic therapy in respiratory tract infections outside of study conditions: a post-study surrey [J]. Eur J Clin Microbiol Infect Dis, 2010,29(3):269-277.
[6]  Casado Flores J,Blanco Quiros A.Procalcitionin,a new marker for bacterial infection [J].An Esp Pediatr,2001,54:69-73.
[7]  Christ M,Stolz D,Bingisser R,et al.Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia:a randomized trial [J].Am J Respir Crit Care Med,2006,174(1):l4-93.
[8]  马明洲,张静,秦海东,等.动态监测血清降钙素原在短程抗菌治疗策略中的临床价值 [J].实用医学杂志,2010,26(7):1168-1170.
[9]  Assicot M,Gendrel D,CarsinH,et al.High serum procalcitonin concentrations in patients with sepsis and infection [J].Lancet,1993,341(8844):515-518.
[10]  Miedema KG,de Bont ES,Elferink RF,et al.The diagnostic value of CRP,IL-8,PCT,and TREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia [J].Support Care Cancer,2011,19(10):1593-1600.
[11]  Assumma M,Signore F,Pacifico L,et al.Serum Procalcitonin concentrations in term delivering mothers and their healthy offspring:a longitudinal study [J].Clin Chem,2000,183:1583-1587.
[12]  Maniaci V,Dauber A,Weiss S,et al.Procalcitonin in young febrile infants for the detection of serious bacterial infections [J].Pediatrics,2008,122(4):701-710.
[13]  Lacour AG,Zamora SA,Gervaix A.A score identifying serious bacterial infections in children with fever without source [J].Pediatr Infect Dis,2008,27(7):654-656.
[14]  Schuetz P,Christ-Crain M,Thomann R, et al. Effect of procalcitonin based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial [J]. JAMA,2009,302(10):1059-1066.
[15]  Nobre V,Harbarth S,Graf JD,et al. Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial [J]. Am J Respir Crit Care Med,2008,177(5):498-505.
[16]  Albrich wc,Monnet DL,Harbarth S. Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes[J]. Emerg Infect Dis,2004,10(3):514-517.

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