334例脊柱结核临床特点分析

Analysis of Clinical Characteristics of 334 Cases of Spinal Tuberculosis

目的分析脊柱结核病的临床特点,为该病的预防提供临床经验。方法采用回顾性分析方法收集脊柱结核患者334例,分析患者的性别、年龄、职业、病程、是否合并肺结核与脊柱结核发病的关系,总结脊柱结核的临床症状、发病部位、累及节段、实验室检验及治疗方法的特点。结果 334例患者中,男女患者性别比为1∶1.14。发病年龄以40岁～最多,占20.06%。职业分布中农民最多,占67.07%。临床表现以腰痛最多,占88.6%。病变部位主要累及腰椎,占41.92%。结核感染T淋巴细胞酶联免疫斑点试验检验脊柱结核的灵敏度为87.5%,高于结核抗体和结核分枝杆菌脱氧核糖核酸检验的灵敏度(P<0.05)。有79例患者口服抗结核药物保守治疗,225例患者行手术治疗。结论脊柱结核主要发生于青壮年农民患者。脊柱结核临床表现以腰痛最常见,病变多累及腰椎单节段。结核感染T淋巴细胞酶联免疫斑点试验诊断脊柱结核价值较大。经口服抗结核药或必要的手术治疗可获得满意疗效。

Objective To analyze the clinical features of spinal tuberculosis and provide clinical experience for the prevention of this disease.Methods A retrospective analysis method was used to collect 334 patients with spinal tuberculosis diagnosed.The relationship between gender,age,occupation,course of disease,whether tuberculosis combined with the incidence of spinal tuberculosis were analyzed,and the characteristics of clinical symptoms,site of onset,involvement of segments,laboratory tests and treatment methods were summarized.Results Of the 334 patients,the ratio of male to female was 1:1.14.The age of onset was 40-years old,accounting for 20.06%.The largest number was farmer in the occupational distribution,accounting for 67.07%.The clinical manifestations were the highest in low back pain,accounting for 88.6%.The lesion mainly involved the lumbar vertebrae,accounting for 41.92%.The sensitivity of tuberculosis-infected T lymphocyte enzyme-linked immunospot assay for spinal tuberculosis was 87.5%,which was higher than the sensitivity of tuberculosis antibody and mycobacterium tuberculosis DNA test(P<0.05).There were 79 patients who received oral anti-tuberculosis drugs and 225 patients underwent surgery.Conclusion Spinal tuberculosis mainly occurs in young and middle-aged farmers.The clinical manifestations of spinal tuberculosis are most common with low back pain,and the lesions involve a single segment of the lumbar spine.The tuberculosis infected T lymphocyte enzyme-linked immunospot assay is more valuable in the diagnosis of spinal tuberculosis.Satisfactory results can be obtained by oral anticonvulsant or necessary surgical treatment.