术后椎间盘炎的血沉与C反应蛋白分析比较

Quantitative analysis of erythrocyte sedimentation rate and C-reactive protein levels of postoperative discitis

目的: 探讨腰椎术后椎间隙感染的ESR和CRP特征性改变及早期诊断价值。方法: 回顾 25例行椎板减压髓核摘除术并发椎间隙感染的患者以及前瞻性研究 50例同种手术无感染的患者, 分别于术前、术后 2d、1、2周以及 4周进行ESR和CRP分析对比。结果: 所有患者术后均出现不同程度的ESR和CRP增快, 与术前相比有显著性差异 (P<0. 01), 感染组与非感染组同期比较没有统计学差异 (P>0. 05); 同期CRP与ESR相比, 峰值出现更早, 持续时间更短。结论: 两组ESR和CRP虽没有统计学差异, 但仍是早期诊断椎间盘感染的一种简单、有效和经济的术后常规筛选检查指标, 而且动态监测时间越长, 升高越快, 诊断价值越大。

Objective:Discitis after discectomy is frequently missed or detected too late because of false interpretation of postoperative complaints and examinations.The authors want to evaluate the value of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)as early detectors of postoperative infection as well as for monitoring recovery after infection.Method:The authors reviewed 25 patients who were diagnozed discitis and examined prospectively 50 patients after single-level discectomy,C-reactive protein and ESR were measured before surgery and on days 2、7、14,and 28 after operation.Result:The CRP and ESR levels increased in all patients after operation,with peak values for CRP 2 to 3 days after surgery,whereas the ESR peak occurred approximately on the seventh postoperative day.The CRP and ESR levels of discitis group were more higher than those of non-discitis group.Conclusion: The ESR and CRP monitoring are sensitive and economical parameter to recongize discitis.CRP is presumably a better test than ESR for early detection of postoperative infection.