老年患者腰椎术后CRP与ESR的表达变化及临床意义

Expression and clinical significance of CRP and ESR in elderly patients after lumbar surgery

目的研究老年患者腰椎术后C反应蛋白(CRP)和红细胞沉降率(ESR)的变化水平和其临床意义。方法选择自2016年5月—2017年6月在长兴县人民医院接受腰椎术的176例老年患者。其中15例患者在术后发生感染,作为感染组;161例患者术后未发生感染,作为对照组,检测患者在术前和术后第1、3、5、7、14、21天血清中CRP及ESR变化水平。结果感染组和对照组患者在腰椎术前CRP分别为(9.5±2.6)mg/L、(9.8±1.9)mg/L,差异无统计学意义(t=0.565,P=0.573);术后第3天2组CRP分别为(121.8±3.2)mg/L、(35.0±4.3)mg/L,差异有统计学意义(t=97.372,P<0.001)。感染组和对照组患者在腰椎术前ESR分别为(16.3±3.2)mm/h、(16.6±2.9)mm/h,差异无统计学意义(t=0.380,P=0.704);术后第3天2组CRP分别为(75.4±6.8)mm/h、(36.0±4.6)mm/h,差异有统计学意义(t=21.947,P<0.001)。感染组患者在腰椎术后21 d内CRP和ESR平均水平显著高于对照组,术后均随时间呈递增趋势,CRP水平在术后第3天达到峰值,再逐步下降。感染组患者术后CRP与ESR峰值均显著大于非感染组。结论老年患者在接受腰椎术治疗后同时检测CRP水平及ESR水平可以更有效地判断患者术后是否发生感染,以便及早发现、及早治疗。

Objective To investigate the changes of C reactive protein( CRP) and erythrocyte sedimentation rate( ESR)in elderly patients after lumbar surgery and their clinical significance. Methods A total of 176 elderly patients undergoing lumbar surgery in our hospital from May,2016 to June,2017 were selected. Fifteen patients,got postoperative infection,which were included as infection group; 161 patients without postoperative infection were included as the control group. The levels of CRP and ESR in 1,3,5,7,14 and 21 d in serum before and after operation were detected. Results The CRP level of the infection group and the control group of patients before lumbar operation were( 9. 5 ± 2. 6) mg/L and( 9. 8 ± 1. 9) mg/L,there was no statistically significant difference( t = 0. 565,P = 0. 573); The CRP level after lumbar operation of two groups were( 121. 80 ± 3. 2) mg/L and( 35. 0 ± 4. 3) mg/L,the difference was statistically significant. The ESR level of the infection group and the control group of patients before lumbar operation were( 16. 3 ± 3. 2)mm/h and( 16. 6 ± 2. 9) mm/h,there was no statistically significant difference; The ESR level after lumbar operation of two groups were( 75. 4 ± 6. 8) mm/h and( 36. 0 ± 4. 6) mm/h,the difference was statistically significant( t = 21. 947,P < 0. 001). The average level of CRP3 and ESR in the infection group after lumbar surgery in 21 d was significantly higher than that in the control group,which showed an increasing trend with time,and reached the peak value at 3 d after the operation,and then decreased gradually. CRP and ESR peak of the infection group of patients were significantly higher than that of control group. Conclusion The elderly patients undergoing lumbar surgery after treatment was detected in the CRP level and ESR level can more effectively judge the postoperative infection,so that early detection and early treatment.