降钙素原在化脓性脊柱炎中的诊断价值分析

Analysis of the diagnostic value of procalcitonin in suppurative spondylitis

目的探讨降钙素原(PCT)对化脓性脊柱炎(PS)的诊断价值。方法收集2022年1月至2023年12月我院确诊的PS患者96例(A组)、脊柱结核(TBS)91例(B组)及骨质疏松性压缩骨折(OVCF)100例(C组)的PCT、C反应蛋白(CRP)、红细胞沉降率(ESR)检测结果,比较三者分别与联合检测对PS、TBS、OVCF诊断敏感度和特异性。计算ROC曲线下面积(AUC),评估三者分别与联合对化脓性脊柱炎的诊断价值。结果C组的发病年龄明显大于A、B组(P<0.05),A与B组之间发病年龄差异无统计学意义(P>0.05);三组PCT、CRP及ESR检测值均数比较差异有统计学意义(P<0.05),均为A组>B组>C组。A组的PCT、CRP、ESR特异度为77.5%、64.4%、57.1%、联合诊断82.7%,敏感度为80.2%、88.5%、88.5%、联合诊断94.7%,AUC分别为0.820、0.720、0.779、联合诊断0.804,均有诊断价值(AUC>0.5),其中,PCT>ESR、PCT>CRP、三者联合>CRP(P<0.05),ESR与CRP、PCT与三者联合、ESR与三者联合之间差异无统计学意义(P>0.05)。B组PCT、CRP、ESR的特异度为59.2%、51.0%、49.0%、联合诊断75.2%,敏感度为43.9%、62.6%、73.6%、联合诊断81.3%,AUC分别为0.740、0.664、0.624、联合诊断0.663,均有诊断价值(AUC>0.5),其中,PCT>ESR、PCT>CRP、PCT>三者联合(P<0.05),ESR与CRP、三者联合与ESR、三者联合与CRP之间差异无统计学意义(P>0.05)。结论(1)PCT、CRP、ESR及三者联合在诊断PS均具有一定的临床价值,PCT和PCT联合CRP、ESR对PS诊断的特异性优于CRP、ESR。(2)PCT和PCT联合CRP、ESR对PS鉴别TBS及OVCF均有较高的诊断效能。

Objective To investigate the diagnostic value of procalcitonin(PCT)in pyogenic spondylitis(PS).Methods The results of PCT,C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)of 96 patients with pyogenic spondylitis(PS)(group A),91 patients with tuberculosis spondylitis(TBS)(group B)and 100 patients with osteoporotic vertebral compression fractures(OVCF)(group C)diagnosed in our hospital from January 2022 to December 2023 were collected.The sensitivity and specificity of the three indexes and their combination in the diagnosis of PS,TBS and OVCF were compared.The area under the ROC curve(AUC)was calculated to evaluate the diagnostic value of the three alone and in combination for pyogenic spondylitis.Results The age of onset in the group C was significantly older than that in the group A and B(P<0.05),but there was no significant difference in the age of onset between the group A and the group B(P>0.05).There were significant differences in the mean values of PCT,CRP and ESR among the three groups(P<0.05),that was,the group A>the group B>the group C.The specificities of PCT,CRP and ESR in the group A were 77.5%,64.4%and 57.1%,respectively and 82.7%for combined diagnosis.The sensitivities of PCT,CRP and ESR in the group A were 80.2%,88.5%and 88.5%,respectively and 94.7%for combined diagnosis.The AUC of PCT,CRP and ESR in the group A were 0.820,0.720,and 0.779,respectively and 0.804 for combined diagnosis.All of them had diagnostic value(AUC>0.5).Among them,PCT>ESR,PCT>CRP,and the combination of the three>CRP(P<0.05).There was no significant difference between ESR and CRP,PCT and the combination of the three,and ESR and the combination of the three(P>0.05).The specificity of PCT,CRP and ESR in the group B was 59.2%,51.0%,49.0%,respectively and 75.2%for combined diagnosis.The sensitivities of PCT,CRP and ESR in the group B were 43.9%,62.6%,73.6%,respectively and 81.3%for combined diagnosis.The AUC of PCT,CRP and ESR in the group B were 0.740,0.664 and 0.624,respectively and 0.663 for combined diagnosis.All of them had diagnostic value(AUC>0.5).Among them,PCT>ESR,PCT>CRP,and PCT>the combination of the three(P<0.05).There was no significant difference between ESR and CRP,the combination of the three and ESR,and the combination of the three and CRP(P>0.05).Conclusions ①PCT,CRP,ESR and their combination have certain clinical value in the diagnosis of PS.The specificity of PCT and PCT combined with CRP and ESR in the diagnosis of PS is better than that of CRP and ESR.②PCT and PCT combined with CRP and ESR have high diagnostic efficacy for PS in the differential diagnosis of TBS and OVCF.