脊柱结核和布鲁氏菌性脊柱炎患者外周血生化常规指标、ESR及CRP的水平变化及临床意义

Changes and clinical significance of peripheral blood biochemical routine indexes,ESR and CRP levels in patients with spinal tuberculosis and brucellosis spondylitis

目的分析脊柱结核(STB)与布鲁氏菌性脊柱炎(BS)患者外周血生化常规指标、红细胞沉降率(ESR)及C反应蛋白(CRP)的水平变化和临床意义。方法选取宁夏医科大学总医院2013年1月至2019年1月住院行手术治疗的STB及BS患者共539例为研究对象,其中STB患者350例为STB组,BS患者189例为BS组。比较两组生化常规指标[血氯、清蛋白(ALB)、球蛋白、胆固醇(CHOL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)]、CRP及ESR水平,比较两组不同年龄段、男性与女性患者上述指标水平。结果STB组AST、ALT、ALP水平低于BS组,ALB水平高于BS组,差异均有统计学意义(P<0.05)。年龄≤40岁患者中,STB组ALT水平低于BS组,差异均有统计学意义(P<0.05);年龄>40~60岁患者中,STB组ALB水平高于BS组,ALT水平低于BS组,差异均有统计学意义(P<0.05);年龄>60岁患者中,STB组ALT水平低于BS组,CHOL水平高于BS组,差异均有统计学意义(P<0.05)。男性患者中,STB组ALT、AST及ALP水平均低于BS组,ALB水平高于BS组,差异均有统计学意义(P<0.05)。结论BS与STB患者外周血AST、ALT、ALP、ALB水平存在差异,且与年龄和性别有一定关系,可能在BS与STB的鉴别诊断、疗效评估等方面具有一定的临床应用价值。

Objective To analyze the changes and clinical significance of peripheral blood biochemical routine indexes,erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels in the patients with spinal tuberculosis(STB)and brucellosis spondylitis(BS).Methods A total of 539 STB and BS patients who underwent surgical treatment in General Hospital of Ningxia Medical University from January 2013 to January 2019 were selected as the research subjects.Among them,350 cases of STB were in the STB group,and 189 cases of with BS were in the BS group.The levels of biochemical routine indexes[serum chlorine,albumin(ALB),globulin,cholesterol(CHOL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)],CRP and ESR were compared between the two groups.The levels of the above indexes in different age groups,male and female patients were compared between the two groups.Results The levels of AST,ALT and ALP in the STB group were lower than those in the BS group,the ALB level was higher than that in the BS group,and the differences were statistically significant(P<0.05).Among the patients aged≤40 years old,the ALT level in the STB group was lower than that in the BS group,and the difference was statistically significant(P<0.05).Among the patients aged>40-60 years old,the ALB level in the STB group was higher than that in the BS group,the ALT level was lower than that in the BS group,and the differences were statistically significant(P<0.05).Among the patients over 60 years old,the ALT level in the STB group was lower than that in the BS group,the CHOL level was higher than that in the BS group,and the differences were statistically significant(P<0.05).Among male patients,the levels of ALT,AST and ALP in the STB group were lower than those in the BS group,the ALB level was higher than that in the BS group,and the differences were statistically significant(P<0.05).Conclusion There are differences in the levels of AST,ALT,ALP and ALB in the peripheral blood of the patients with BS and STB,which has a ceratain relationship with the age and gender,and may have a certain clinical application value in the differential diagnosis and efficacy evaluation of BS and STB.