ESR及CRP在兔脊柱结核模型构建中的变化规律研究  

Study on the change of ESR and CRP in the building of rabbit spinal tuberculosis model

作　　者：岳学锋[1] 王鹏[1] 施建党[2] 赵晨[1] 苏胜杰[1] 杨宗强[1] 何胤[1] 

机构地区：[1]宁夏医科大学研究生学院,银川750004 [2]宁夏医科大学总医院脊柱骨科,银川750004

出　　处：《安徽医科大学学报》2017年第6期833-839,共7页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81360275);宁夏自然科学基金(编号:NZ13131);宁夏医科大学重点项目(编号:XZ2015015)

摘　　要：目的观察红细胞沉降率(ESR)及C反应蛋白(CRP)在新西兰兔脊柱结核模型构建中的变化规律。方法45只新西兰兔随机分为造模组(n=25)、对照组(n=20)。造模组于腰4、5椎间隙钻孔,填入明胶海绵,在其中浸注H37Rv结核标准菌株混悬液0.1 ml;对照组浸注生理盐水0.1 ml。观察实验兔一般状况,并通过影像学、病理学、微生物学评估造模情况;观察两组实验兔术前、术后(1、3、5、7、10、14、28、42、56 d)不同时间点ESR及CRP的变化规律;探讨ESR及CRP与兔脊柱结核感染的相关性。结果术后56 d造模组21只实验兔最终完成实验,对照组为18只。通过影像学、病理学、微生物学评估:造模组脊柱结核造模感染阳性率为76.19%(16/21),造模阳性兔均至少符合一项造模阳性判定标准;造模组另5只造模阴性兔及对照组实验兔均无阳性发现。动态观察两组ESR、CRP的变化规律:造模组阳性兔体内的ESR、CRP变化规律与造模组阴性兔明显不同,而造模组阴性兔体内的ESR、CRP变化规律与对照组相似;造模组阳性兔术后ESR及CRP迅速升高,ESR术后第7天达到高峰,CRP术后5 d达高峰,至术后42 d已趋于平稳,术后56 d处死动物时ESR及CRP仍维持在较高水平;造模组阴性兔及对照组实验兔ESR在术后第7天达高峰,此后逐渐下降,至术后42 d已降至术前水平,CRP术后第3天达高峰后逐渐下降,至术后28 d降至术前水平;造模组阳性兔ESR、CRP达高峰时所测值及实验结束时(56 d)所测值均高于造模组阴性兔和对照组同时间点所测值(P<0.05);绘制术后56 d时ESR、CRP与结核造模感染相关性的ROC曲线,曲线下面积:ESR为0.953,CRP为0.927,均显著大于0.5,以Youden指数最大的切点为最佳筛选点计算:ESR最佳筛选点为7.5 mm/h,CRP最佳筛选点为5 527.50μg/L。结论ESR及CRP可反映模型兔体内结核菌感染情况及病情进展,造模术后56 d检测值可作为筛选兔脊柱结核动物模型的可靠指Objective To observe the erythrocyte sedimentation rate （ESR） and C reactive protein （CRP） chan- ges in the New Zealand rabbit model of spinal tuberculosis. Methods New Zealand rabbits were randomly divided into two groups ： 25 in the model group and 20 in the control group. The module was drilled in the lumbar 4 and 5 intervertebral spaces, filling in the gelatin sponge, in which the infusion of H37Rv tuberculosis standard strain sus- pension was 0. 1 ml; the control group was injected with saline 0. 1 ml. The general condition of rabbits were ob- served, and by imaging, pathology, microbiology to evaluate model conditions; to observe the changes of ESR and CRP at different time points before and after operation （1, 3, 5, 7, 10, 14, 28, 42, 56 d）. The correlation be- tween ESR and CRP and spinal tuberculosis infection in rabbits was investigated. Results 56 days after the opera- tion, 21 rabbits of model group were finished, and in the control group was 18. By imaging, pathology, microbiolo- gy： in the model group, spinal tuberculosis infection positive rate was 16/21 （76. 19% ） ,with at least one model positive criterion; In model group, the other 5 rabbits in control group and negative rabbits were not found. The changes of ESR and CRP of positive rabbits in model group were significantly different from those of negative rabbits in model group, while the changes of ESR and CRP of negative rabbits in model groups were similar to those in control group. The changes of ESR and CRP of positive rabbits in model group were significantly different from those of negative rabbits in model group, while the changes of ESR and CRP of negative rabbits in model groups were similar to those in control group. The ESR and CRP increased rapidly after operation, and the peak value of ESR was （16. 87 ± 3.97 ）mm/h on the 7th day after operation. CRP peaked at the 5th day after operation （ 12 984.25 ±1 063.35 ） g/L, and the values of ESR and CRP were stable at 42 days after surgery, ESR and CRP

关 键 词：脊柱结核 动物模型 兔 红细胞沉降率 C反应蛋白 

分 类 号：R681.5[医药卫生—骨科学] R322[医药卫生—外科学]