The value of PCT dynamic monitoring in guiding the severity and antibiotic treatment in elderly patients with acute exacerbation of chronic obstructive pulmonary disease
CHI Feng
ZHANG Shu
YAO Xiaoyang
BAI Chong
Abstract：Objective To explore the value of serum procalcitonin (PCT) in guiding the severity and antibiotic treatment in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Sixty-eight elderly AECOPD patients who received treatment in Seventh People's Hospital, Shanghai University of TCM from Oct 2014 to Oct 2015 were divided into two groups, including 34 patients of control group,34 patients of experimental group.Control group was given antibiotic therapy guided by clinical symptoms, white blood cell (WBC) and C reactive protein (CRP).Experimental group received antibiotic therapy according to the level of serum PCT.The changes of the serum PCT, WBC and CRP, blood gas indicators at different time point, prognosis between two groups were compared.Results From 3rd and 7th day after admission, the serum PCT, WBC, CRP in AECOPD patients were all reduced compared with those at admission.The levels of serum PCT and CRP in experimental group were significantly lower than those in control group (F =6.23, F =4.23, P <0.01), while there was no statistically significant difference on the level of WBC at the same time between two groups (F =2.18, P =0.062).From 3rd day after admission, the levels of pH, PaCO2, PaO2, SaO2 were all improved compared with before treatment, and these indicators in experimental group were significantly better than those in control group (F =8.98, F =5.92, F =7.97, F =4.29, P <0.01).Compared with experiential treatment group, the time of hospital stay, time of antibiotics therapy in experimental group was significantly reduced, and the costs of antibiotics also reduced (t =9.33, t =38.04, t =11.95,all P <0.01), recurrence rate and mortality were significantly decreased (χ2=4.66,χ2=3.98, P =0.031, P =0.047).Conclusion Serum PCT dynamic monitoring can guide and optimize the antibiotic treatment strategy, and improve the disease outcome in elderly patients with AECOPD.
Keywords：Acute exacerbation of chronic obstructive pulmonary diseaseProcalcitoninAntibiotics
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 881-884 )