血清降钙素原在慢性阻塞性肺疾病急性加重患者治疗中的价值研究

潘雯; 张灵健; 沈智文; 贾敏; 王俊彦; 朱晓红

doi:10.11847/zgggws1133983

血清降钙素原在慢性阻塞性肺疾病急性加重患者治疗中的价值研究

Indicative significance of serum procalcitonin in antimicrobial therapy for patients with acute exacerbation of chronic obstructive pulmonary disease: a meta-analysis

摘要

摘要:
目的系统评价血清降钙素原（PCT）在慢性阻塞性肺疾病急性加重（AECOPD）抗感染治疗中的价值。
方法以“ 降钙素原”、“ 慢性阻塞性肺疾病”、“随机对照试验”检索PubMed、EMBASE、Cochrane Library等数据库中相关的文献，提取相关信息，进行系统评价。
结果最终纳入了6项RCTs，共1096例患者；随机效应模型结果显示，PCT组的抗菌药物处方率比对照组低27 %（RR = 0.73，95 % CI：0.58～0.92，I ² = 65.3 %）。
结论血清 PCT在AECOPD患者抗菌药物使用过程中具有重要提示意义，其临床价值较确定，但具体临界值尚需进一步研究确认。

Abstract:
Objective To systematically evaluate clinical significance of procalcitonin (PCT) as an indicator for antimicrobial treatment for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Methods Using medical subject headings (MeSH) including “procalcitonin”, “pulmonary disease, chronic obstructive”, and “randomized controlled trial”, we searched PubMed, EMBASE, Cochrane Library databases for relevant randomized controlled trials (RCTs) published up to June 2020. Two researchers screened retrieved literatures independently according to the inclusion and exclusion criteria and then extracted relevant information. Statistical analysis was conducted using STATA 12.0 software.
Results Six RCTs, with a total of 1 096 patients, were included in the analysis. The results showed that the prescription rate of antimicrobial drugs in the PCT group was 27% lower than that in the control group (relative risk = 0.73, 95% confidence interval: 0.58 – 0.92; I ² = 65.3%).
Conclusion Serum PCT is an important indicator for antibacterial treatment in AECOPD patients but the specific critical value for evaluating antibacterial therapy needs to be studied further.

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