| 脊柱结核围手术期ESR及CRP多样性临床分析 |
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投稿时间：2009-11-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 郭立新 |
GUO Li-xin |
解放军309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
glx-tb@tom.com |
| 马远征 |
MA Yuan-zheng |
解放军309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 李宏伟 |
LI Hong-wei |
解放军309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 薛海滨 |
XUE Hai-bin |
解放军309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 彭伟 |
PENG Wei |
解放军309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 罗小波 |
LUO Xiao-bo |
解放军309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第3期，第200-202页 |
| DOI：10.3969/j.issn.1003-0034.2010.03.016 |
| 基金项目: |
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中文摘要:
目的：探讨脊柱结核围手术期血沉(ESR)和C反应蛋白(CRP)多样性改变的临床意义。
方法：67例脊柱结核选自2004年3月至2007年3月短程化疗加手术治疗患者，男41例，女26例；年龄23～61岁。结核病灶位于颈椎7例，胸椎31例，腰骶椎29例。化疗方案为3HRZ/5～7HRE,手术方法为Ⅰ期病灶清除、自体植骨和坚强内固定。动态观察ESR和CRP变化、结核症状改善和病灶愈合进程。
结果：入选病例结核病灶处于活跃期，ESR平均值(79.4±35.6) mm/h,CRP平均值(44.3±17.5) mg/L.术前化疗4～6周结核症状改善明显，ESR平均值降至(45.3±21.0) mm/h,CRP平均值降至(26.7±11.8) mg/L,均显着下降(P<0.05).术后第1周ESR平均值升至(83.2±37.4) mm/h,CRP平均值回升至(53.0±18.6) mg/L.术后第4周ESR平均值降至(42.8±16.5) mm/h,CRP平均值降至(23.8±10.0) mg/L.术后第8周所有患者结核症状缓解，其中47例ESR和CRP恢复正常，其余20例ESR和CRP在术后第12周恢复正常。短程化疗期满时有65例结核病灶治愈，2例因肝损害停用抗结核药而导致病灶重新活跃，ESR和CRP明显异常。
结论：脊柱结核围手术期ESR和CRP呈多样性改变，是脊柱结核手术时机选择和临床疗效评估的重要参考指标。 |
| 【关键词】结核，脊柱 抗结核药 围手术期 血沉 C反应蛋白 |
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| Variety of ESR and C-reactive protein levels during perioperative period in spinal tuberculosis |
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ABSTRACT
Objective: To investigate the clinical significance of erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) in the treatment of spinal tuberculosis.
Methods: Sixty-seven patients(41 males and 26 females,ranging in age from 23 to 61 years)with active spinal tuberculosis in our hospital(from Mar.2004 to Mar.2007) were included in this study. The tuberculosis focus were located either in cervical spine,thoracic spine or in lumbar spine. After 4 to 6 weeks anti-tuberculosis chemotherapy,all the patients underwent one-stage operation(focus debridment) and auto-bone graft combined with internal fixation. Blood test for ESR and CRP were carried out at different times before and after operation.
Results: The average ESR was(79.4±35.6)mm/h,and the average CRP was(44.3±17.5) mg/L before chemotherapy,indicating active tuberculosis focus. After 4 to 6 weeks chemotherapy,the average ESR was(45.3±21.0) mm/h,and the average CRP was(26.7±11.8) mg/L,the differences were statistically(P<0.05),and the clinical symptoms of spinal tuberculosis relieved in all patients. Four weeks after operation,the average ESR dropped to(42.8±16.5)mm/h,the average CRP dropped to(23.8±10.0)mg/L statistically(P<0.05). Eight weeks after operation,the average value of ESR and CRP were at normal level in 47 cases,indicating inactive tuberculosis focus. Focus healing was achieved in 65 patients after short-term chemotherapy.
Conclusion: The level of ESR and CRP are high in active spinal tuberculosis and low when focus controlled. ESR and CRP are reliable parameters in evaluation the treatment and prognosis of spinal tuberculosis. |
| KEY WORDS Tuberculosis,spinal Antitubercular agents Peroperative period Blood sedimentation C- reactive protein |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 郭立新,马远征,李宏伟,薛海滨,彭伟,罗小波.脊柱结核围手术期ESR及CRP多样性临床分析[J].中国骨伤,2010,23(3):200~202 |
| 英文格式: | GUO Li-xin,MA Yuan-zheng,LI Hong-wei,XUE Hai-bin,PENG Wei,LUO Xiao-bo.Variety of ESR and C-reactive protein levels during perioperative period in spinal tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(3):200~202 |
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