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,均显著下降(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。
Objective：To investigate the clinical significance of erythrocyte sedimentation rate （ESR） and C reactive pro- tein（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 tu- berculosis 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 af- ter 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 tu- berculosis 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.
出处
《中国骨伤》
CAS
2010年第3期200-202,共3页
China Journal of Orthopaedics and Traumatology
关键词
结核
脊柱
抗结核药
围手术期
血沉
C反应蛋白
Tuberculosis
spinal
Antitubercular agents
Peroperative period
Blood sedimentation
C reactive protein
