脊柱结核内植物置入后基于C-反应蛋白及红细胞沉降率多样性与植骨融合时间的相关分析(英文)

C-reactive protein and erythrocyte sedimentation rate associate with bone graft union in patients with spinal tuberculosis following internal fixation

背景:脊柱结核行结核病灶清除、植骨、加或不加钢板内固定后患者C-反应蛋白及红细胞沉降率变化与植骨块骨性融合时间有一定的联系。目的:分析脊柱结核内置物置入后C-反应蛋白及红细胞沉降率动态多样性和植骨融合时间的相关性。方法:60例脊柱结核患者均行结核病灶清除、自体髂骨植骨、加或不加钢板内固定治疗,其中内固定38例,无内固定22例。根据术后C-反应蛋白水平及红细胞沉降率分别分为轻度升高、中度升高、高度升高组和极度升高组。分析术后C-反应蛋白、红细胞沉降率和植骨块骨性融合时间差异性和相关性。结果与结论:①C-反应蛋白:轻度升高18例,中度升高21例,高度升高13例,极度升高8例。4组骨性愈合时间差异有非常显著性意义(P=0.003)。Spearman相关分析显示相关系数为r=0.420,P=0.001,说明术后C-反应蛋白水平多样性与骨性融合时间长短呈正相关。②红细胞沉降率:轻度升高16例,中度升高20例,高度升高13例,极度升高11例。4组骨性愈合时间差异有非常显著性意义(P=0.003)。Spearman相关分析显示相关系数为r=0.414,P=0.001,说明术后红细胞沉降率多样性与骨性融合时间长短呈正相关。③内固定组植骨融合时间快于无内固定组,说明即时坚强内固定有利于促进骨性愈合。

BACKGROUND： Tuberculosis clearance, bone graft, internal fixation with or without plate for patients with spinal tuberculosis always lead to C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） changes, which are associated with bone graft union time to certain degree. OBJECTIVE： To analyze the correlation between CRP, ESR and bone graft union time in patients with spinal tuberculosis. METHODS： A total of 60 patients with spinal tuberculosis underwent tuberculose focus clearance, autologous iliac bone grafting, and internal fixation without or with plate, including 38 undergoing fixation and 22 not undergoing fixation. They were divided into mild elevation, moderate elevation, high elevation, and extremely high elevation groups according to CRP and ESR. Correlation between CRP, ESR and bone graft union time was analyzed. RESULTS AND CONCLUSION： （1） CRP： there were 18 cases of mild elevation, 21 of moderate elevation, 13 of high elevation and 8 of extremely high elevation. There were significant differences in bone union time among groups （P=-0.003）. Spearman correlation analysis showed a correlation coefficient r=0.420, P=-0.001, indicating positive correlation between CPR and bone union time. （2） ESR： there were 16 cases of mild elevation, 20 of moderate elevation, 13 of high elevation and 11 of extremely high elevation. There were significant differences in bone union time among groups （P=0.003）. Spearman correlation analysis showed a correlation coefficient r=0.414, P=0.001, indicating positive correlation between ESR and bone union time. （3） Bone union was rapider in fixation group compared with non-fixation group, indicating that immediate, strong fixation can benefit bone union.