The value of serum procalcitonin in treatment of acute exacerbations of chronic obstructive pulmonary disease / 中华急诊医学杂志

ABSTRACT

Objective To evaluate the value of serum procalcitonin(PCT)on antibiotics use in treatment of acute exacerbations of chronic obstructive pulmonary disease( AECOPD). Method From May 2004 to December 2006, a total of 235 patients requiring hospitalization for AECOPD were randomly assigned into two groups standard therapy group(group A, n = 117)and PCT-guided group(group B, n = 118) .PCT levels of all patients were measured after hospital admission by an amplified cryptate emission technology assay. On the base of similarly normal treatment, group A received antibiotics according to the attending physicians,and group B were treated with antibiotics according to serum PCT levelsantibiotic treatment was applied with PCT level ≥0.25 ng/ml and was discouraged with PCT level ＜0.25 ng/ml. Length of hospitalization,clinical efficacy,costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality,rate of exacerbation and rehospitalization within 1 year were observed. Analyses were performed by t test, Mann-Whitney U test or χ2 test. Results Clinical efficacy, hospital mortality, length of hospitalization, rate of exacerbation and rehospitalization within 1 year were similar in two groups (P =0.635,0.768,0.884,0.747,0.727) ;costs of antibiotics and hospitalization,rate of antibiotics use of PCT-guided group were lower than that of standard therapy group( P = 0.029,0.036,0.014). Conclusions PCT could be used in treatment of AECOPD for antibiotic use after hospital admission,which may reduce antibiotic use and lower costs of antibiotic and hospitalization.