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T浓度＜0.5ng/ml被认为细菌感染可能，建议应用抗生素；PCT浓度≥0.5ng/ml被认为细菌感染存在，强烈建议应用抗生素。在常规抗生素治疗组和PCT指导抗生素治疗组，医师认为按经验应该使用抗生素的患者比率是一样的。与常规抗生素治疗组相比，PCT指导抗生素治疗组接受抗生素患者的比例减少了47%，平均每个患者的抗生素花费减少了52%。但常规抗生素治疗组和PCT指导抗生素治疗组在临床和实验室结局无显著差别。 如同在其他临床领域中一样，PCT在呼吸系统疾病中的价值也日益得到肯定，作为一种标志物，它为临床诊断细菌性下呼吸道感染提供了重要额外的信息。然而必须强调的是，PCT不能替代仔细的问诊和详细的体检。同其他所有诊断实验一样，血清PCT浓度在临床实践中的价值应该不断地被评估和再评估。 【参考文献】 1 Karzai W，Oberhoffer M，Meier Hellmann A，et al.Procalcitonina new indicator of the systemic response to severe infections.Infection，1997，25:329-334. 2 Gendrel D，Raymond J，Assicot M，et al.Measurement of procalcitonin levels in children with bacterial or viral meningitis.Clin Infect Dis，1997，24:1240-1242. 3 Oczenski W，Fitzgerald R D，Schwasrz S.procalcitonin: a new parameter for the diagnosis of bacterial infection in the perioperative period.Eur J Anaesthesiol，1998，15(2):202-209. 4 Benoist J F，Mimoz O，Assicot M.Procalcitonin in severe trauma.Ann Biol Clin，1998，56(5):571-684. 5 Schwenger V，Sis J，Breitbart A，et al.CRP levels in autoimmune disease can be specified by measurement of procalcitonin.Infection，1998，26 (5):274-276. 6 Brunkhorst F M，Forycki Z F，Wagner J.Procalcitonin immunoreactivity in severe human shock.Intens Care Med，1995，Suppl:21. 7 Rau B，Steinbach G，Gansauge F，et al.The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis.Gut，1997，41(6):832-840. 8 Eberhard O K，Langefeld I，Kuse E R，et al.procalcitonin in the early phase after transplantion: will it add to diagnostic accuracy? Clin Transplant，1998，12(3):206-211. 9 Endo S，Kasai T，Inada K.Evaluation of procalcitonin levels in patients with systemic inflammatory response syndrome as the diagnosis of infection and the severity of illness.Kansenshogaku Zasshi，1999，73(3):197-204. 10 Brunhorst F M，Forycki Z F，Beier W，et al.Discrimination of infectious and non infectious etiologies of the adult respiratory distress sydrome （ARDS) with procalcitoonin immunoreactivty.Clin Intens Care，1995，Suppl，6:3. 11 Polzin A，Pletz M，Erbes R.et al.Procalcitonin as a diagnostic tool in lower respiratory tract infections and tuberculosis.Eur Respir J，2003，21(6):939-943. 12 Prat C，Dominguez J，Rodrigo C，et al.Procalcitonin，Creactive protein and leukocyte count in children with lower respiratory tract infection.Pediatr Infect Dis J，2003，22(11):963-968. 13 Moulin F，Raymond J，Lorrot M，et al.Procalcitonin in children admitted to hospital with community acquired pneumonia.Arch Dis Child，2001，84:332-336. 14 Hedlund J，Hansson LO.Procalcitonin and Creactive protein levels in communityacquired pneumonia: correlation with etiology and prognosis，Infection，2000，28(2):68-73. 15 Toikka P，Irjala K，Juven T，et al.Serum procalcitonin，Creactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children.Pediatr Infect Dis J，2000，19(7):598-602. 16 Korppi M，Remes S，HeiskanenKosma T.Serum procalcitonin concentrations in bacterial pneumonia in children: a negative result in primary healthcare settings.Pediatr Pulmonol，2003，35(1):56-61. 17 Korppi M，Remes S.Serum procalcitonin in pneumococcal pneumonia in children.Eur Respir J，2001，17(4):623-7. 18 Chua AP，Lee KH.Procalcitonin in severe acute respiratory syndrome (SARS).J Infect，2004，48(4):303-6. 19 Brunkhorst FM，Al Nawas B，Krummenauer F，et al.Procalcitonin，Creactive protein and APACHE Ⅱ score for risk evaluation in patients with severe pneumonia.Clin Microbiol Infect，2002，8:93-100. 20 Hedlund J，Hansson LO.Procalcitonin and Creactive protein levels in communityacquired pneumonia: correlation with etiology and prognosis.Infection，2000，28(2):68-73. 21 Korppi M，Remes S，HeiskanenKosma T.Serum procalcitonin concentrations in bacterial pneumonia in children: a negative result in primary healthcare settings，Pediatr Pulmonol，2003，35(1):56-61. 22 Luyt CE，Guerin V，Combes A.Procalcitonin kinetics as a prognostic marker of ventilatorassociated pneumonia.Am J Respir Crit Care Med，2005，171(1):48-53. 23 Duflo F，Debon R，Monneret G.Alveolar and serum procalcitonin: diagnostic and prognostic value in ventilatorassociated pneumonia.Anesthesiology，2002，96(1):74-79. 24 Kandemir O，Uluba B，Polat G.Elevation of procalcitonin level in patients with pulmonary tuberculosis and in medical staff with close patient contact.Arch Med Res，2003，34(4):311-314. 25 Cakir E，Deniz O，Ozcan O.Pleural fluid and serum procalcitonin as diagnostic tools in tuberculous pleurisy.Clin Biochem，2005，38(3):234-238. 26 Brunkhorst FM，Eberhard OK，Brunkhorst R.Discrimination of infectious and noninfectious causes of early acute respiratory distress syndrome by procalcitonin.Crit Care Med ，1999 ，27(10) : 2172-2176. 27 Stein PD，Afzal A，Henry JW，et al.Fever in acute pulmonary embolism.Chest，2000，26(8):39-42. 28 Cooper TJ，Prothero DL，Gillett MG，et al.Labotatory investigation in the diagnosis of pulmonary embolism.Q J Med，2004，83(16):369-379. 29 Delevaux I，Andre M，Aumaitre O.Procalcitonin measurement for differential diagnosis between pulmonary embolism and pneumonia.Crit Care Med，2003，31(2):661. 30 Macfarlane JT，Colville A，Guion A，et al.Prospective study of aetiology and outcome of adult lower respiratory tract infections in the community.Lancet，1993，341(3):511-514. 31 Wenzel RP，Wong MT.Managing antibiotic use: impact of infection control.Clin Infect Dis，1999，28:1126-1127. 32 Chen DK，McGeer A，De Azavedo JC，et al.Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada.N Engl J Med，1999，341:233-239. 33 Sethi S，Murphy TF.Bacterial infection in chronic obstructive pulmonary disease in 2000: a stateoftheart review.Clin Microbiol Rev，2001，14:336-363. 34 ChristCrain M，JaccardStolz D，Bingisser R.Effect of procalcitoninguided treatment on antibiotic use and outcome in lower respiratory tract infections: clusterrandomised，singleblinded intervention trial.Lancet，2004，363 (9409) : 600-607. 上一页 [1] [2]
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