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虞富安.血清PCT早期评估对老年心衰合并肺部感染患者预后的影响及临床价值分析[J].浙江中西医结合杂志,2017,27(9):
血清PCT早期评估对老年心衰合并肺部感染患者预后的影响及临床价值分析
The Serum PCT early assessment of heart failure in elderly patients with pulmonary infection and clinical prognosis of Value Analysis
投稿时间:2017-02-24  修订日期:2017-09-08
DOI:
中文关键词:  降钙素原(PCT)  老年  心力衰竭  肺部感染  预后  临床价值
英文关键词:
基金项目:
作者单位E-mail
虞富安 浙江金华广福医院 jifuanzzc@163.com 
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中文摘要:
      目的 探讨血清降钙素原(PCT)早期评估对老年心衰合并肺部感染患者预后的影响,并分析其临床价值。方法 回顾性选择本院2011年1月~2013年8月心力衰竭并发肺部感染98例,根据监测PCT情况分为对照组和研究组,两组各49例,研究组治疗过程中每2~3天检测1次PCT水平后进行治疗,对照组进行常规治疗。评估两组患者机械通气、二重感染及死亡抗菌药物使用时间、使用抗生素种类和住院时间,并评估治疗前后急性生理与慢性健康Ⅱ( APACHE-Ⅱ) 评分和临床肺部感染评分(CPIS)。结果 研究组治疗后CPIS和APACHE-Ⅱ为(7.12±0.68)分和(13.29±2.87)分,低于对照组(8.04±0.81)分和(15.44±2.93)分,差异有统计学意义(P<0.05)。研究组患者机械通气、二重感染、耐药性及死亡发生率为16.33%(8/49)、10.20%(5/49)、26.53%(13/49)和8.16%(4/49),低于对照组34.69%(17/49)22.45%(11/49)、48.98%(24/49)和20.45%(20/49),差异有统计学意义(P<0.05);研究组患者抗生素使用时间、使用抗生素种类、感染控制窗出现时间和住院时间结果为(11.35±1.08)d、(2.31±0.16)种、(10.17±1.19)d和(18.74±0.75)d,低于对照组(11.35±1.08)d、(2.31±0.16)种和(12.38±1.02)d和(18.74±0.75)d,差异有统计学意义(P<0.05)。结论 应用PCT早期评估老年心衰合并肺部感染患者,可有效控制患者肺部感染,改善患者预后,减少患者抗生素使用时间和种类,降低耐药性,缩短治疗时间,具有较高的临床价值。
英文摘要:
      Objective To explore elderly heart failure prognosis of patients with pulmonary infection early assessment of serum PCT, and to analyze its clinical value. Methods 98 heart failure complicated by pulmonary infection were selected in the hospital from January in 2011 to August in 2013.According to the monitoring PCT they were divided into the control group and the study group, 49 cases in each group, the study group treated after PCT levels detected every 2 to 3 day, and the control group were given conventional treatment. To assess mechanical ventilation, use time and the type of antibiotics, double infection and hospitalization time, assess clinical pulmonary infection score (CPIS) and the acute physiological and chronic health Ⅱ (APACHE-Ⅱ) scores before and after treatment.Results CPIS and APACHEⅡ of the study group after treatment was (7.12±0.68) points and (13.29±2.87) points,lower than the control group (8.04±0.81) points and (15.44±2.93) points, the difference was statistically significant (P <0.05) .The mechanical ventilation, double infection and death rate of the study group were 16.33% (8/49), 10.20% (5/49) and 8.16% (4/49), lower than the control group 34.69%(17/49),22.45%(11/49) and 20.45%(20/49), the difference was statistically significant (P<0.05).The use time and the type of antibiotics, infection control window appear time and hospitalization time of the study group were (11.35±1.08) d, (2.31±0.16) species,(10.17±1.19)d and (18.74±0.75) d, lower than the control group (11.35±1.08) d, (2.31±0.16) species,(12.38±1.02)d and (18.74±0.75) d, the difference was statistically significant (P <0.05). Conclusion Application PCT early evaluation of elderly patients with heart failure, pulmonary infection, which can effectively control the infection in the lungs of patients, improved patient outcomes, reduce antibiotic use in patients with the kind of time and reduce the resistance, to shorten the treatment time, with high clinical value.
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