CAJ | 학술논문

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.
배경:척주결핵행결핵병조청제、식골、가혹불가강판내고정후환자C-반응단백급홍세포침강솔변화여식골괴골성융합시간유일정적련계.목적:분석척주결핵내치물치입후C-반응단백급홍세포침강솔동태다양성화식골융합시간적상관성.방법:60례척주결핵환자균행결핵병조청제、자체가골식골、가혹불가강판내고정치료,기중내고정38례,무내고정22례.근거술후C-반응단백수평급홍세포침강솔분별분위경도승고、중도승고、고도승고조화겁도승고조.분석술후C-반응단백、홍세포침강솔화식골괴골성융합시간차이성화상관성.결과여결론:①C-반응단백:경도승고18례,중도승고21례,고도승고13례,겁도승고8례.4조골성유합시간차이유비상현저성의의(P=0.003).Spearman상관분석현시상관계수위r=0.420,P=0.001,설명술후C-반응단백수평다양성여골성융합시간장단정정상관.②홍세포침강솔:경도승고16례,중도승고20례,고도승고13례,겁도승고11례.4조골성유합시간차이유비상현저성의의(P=0.003).Spearman상관분석현시상관계수위r=0.414,P=0.001,설명술후홍세포침강솔다양성여골성융합시간장단정정상관.③내고정조식골융합시간쾌우무내고정조,설명즉시견강내고정유리우촉진골성유합.
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.