目的 探讨多层螺旋CT(MSCT)结 合血清降钙素原(PCT)水平指导慢性阻塞 性肺疾病(COPD)急性发作期患者抗菌药 物应用的临床价值。方法 选取2016年2 月-2018年2月本院收治的100例COPD急性 发作期患者为研究对象，随机数字表法将 其分为对照组和观察组各50例，对照组在 血清PCT水平指导下选择抗菌药物治疗， 观察组在MSCT结合血清PCT水平指导下进 行抗菌药物治疗，观察治疗后两组实验室 指标变化、抗菌药物疗程、住院时间、治 疗费用、随访预后及药物安全性。结果 治疗前两组WBC、CRP及PCT相较无明显差 异(P＞0.05)；与治疗前相较，治疗后两 组WBC、CRP及PCT均明显降低，且治疗后 观察组WBC、CRP及PCT明显低于对照组， 差异有统计学意义(P＜0.05)；观察组抗 菌药物疗程、住院时间较对照组明显短， 治疗费用较对照组明显低，差异显著(P ＜0.05)。结论 MSCT结合血清PCT水平在 COPD急性发作期患者抗菌药物应用中有一 定临床指导作用。

Objective To investigate the clinical value of multi-slice spiral CT (MSCT) combined with serum procalcitonin (PCT) level in guiding the use of antimicrobial agents in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 100 patients with acute exacerbation of COPD who were admitted to the hospital from February 2016 to February 2018 were selected as study subjects. They were divided into the control group and the observation group by the random number table method, with 50 cases in each group. The control group was treated with selected antimicrobial agents under the guidance of serum PCT level while the observation group was treated with selected antimicrobial agents under the guidance of MSCT combined with serum PCT level. Changes of laboratory indicators before and after treatment, course of treatment with antimicrobial agents, length of hospital stay, treatment cost, followup prognosis and drug safety were observed. Results There was no significant difference in WBC, CRP or PCT between the two groups before treatment (P>0.05). The WBC, CRP and PCT in both groups were significantly decreased after treatment, and they were significantly lower in the observation group than in the control group (P<0.05). The course of treatment with antimicrobial agents and length of hospital stay of the observation group were significantly shorter than those of the control group, and the treatment cost was significantly less than the control group(P<0.05). Conclusion MSCT combined with serum PCT level is of certain clinical guiding value in the use of antimicrobial agents in patients with acute exacerbation of COPD.