血清结核杆菌Hsp10检测和MRI诊断脊柱结核的临床价值  

Clinical value of serum Mycobacterium tuberculosis Hsp10 detection and MRI in the diagnosis of spinal tuberculosis

作　　者：张军 张小刚 周涛 陈富春 白正发 ZHANG Jun;ZHANG Xiao-gang;ZHOU Tao;CHEN Fu-chun;BAI Zheng-fa(Imaging Department,the Fourth People's Hospital of Shaanxi,Xi'an 710043,China)

机构地区：[1]陕西省第四人民医院影像科,陕西西安710043

出　　处：《临床医学研究与实践》2018年第35期110-112,共3页Clinical Research and Practice

摘　　要：目的探讨血清结核杆菌热休克蛋白10(Hsp10)水平检测和核磁共振(MRI)在脊柱结核诊断中的临床价值。方法选取我院2017年3月至2018年4月收治的67例可疑脊柱结核患者作为观察组,其中包括确诊的43例脊柱结核患者和24例非脊柱结核患者,另选取35例健康志愿者作为健康对照组。观察组患者实施结核菌素(PPD)试验;检测三组受试者静脉血结核杆菌Hsp10水平;并对观察组患者分别进行CT、MRI影像诊断,然后对其临床诊断结果进行比较。结果脊柱结核组血清结核杆菌Hsp10水平明显高于非脊柱结核组和健康对照组(P<0.05),而非脊柱结核组和健康对照组之间无显著差异(P>0.05)。血清结核杆菌Hsp10诊断脊柱结核的灵敏度为81.40%,特异度为70.83%,均高于PPD试验诊断脊柱结核的灵敏度(62.79%)和特异度(54.17%)。CT、MRI检查对骨质椎间盘损伤、椎旁损伤的检出率无显著差异(P>0.05);MRI检查对硬膜囊肿、脊膜强化、韧带扩散的检出率明显高于CT检查(P<0.05);CT检查对钙化的检出率明显高于MRI检查(P<0.05)。MRI诊断脊柱结核的灵敏度为93.02%,特异度为87.50%,均高于CT诊断脊柱结核的灵敏度(44.19%)和特异度(79.17%)。结论血清结核杆菌Hsp10水平检测和MRI对脊柱结核均有较高的诊断价值,若能够将两者联合则可明显提高诊断准确率,对脊柱结核的早期诊断和治疗有重要意义。Objective To explore the clinical value of detection of serum Mycobacterium tuberculosis heat shock protein 10(Hsp10)level and magnetic resonance imaging(MRI)in the diagnosis of spinal tuberculosis.Methods Sixty-seven patients with suspected spinal tuberculosis admitted in our hospital from March 2017 to April 2018 were selected as observation group,including 43 patients with confirmed spinal tuberculosis and 24 patients with non-spinal tuberculosis.Another 35 healthy volunteers were selected as healthy control group.The patients in the observation group were tested for tuberculin purified protein derivative(PPD)test,and the levels of Hsp10 in venous blood of subjects of the three groups were detected.The patients in the observation group were diagnosed by CT and MRI respectively,and then the clinical diagnosis results were compared.Results The level of serum Mycobacterium tuberculosis Hsp10 in the spinal tuberculosis group was significantly higher than those in the non-spinal tuberculosis group and the healthy control group(P<0.05),but there was no significant difference in which between the non-spinal tuberculosis group and the healthy control group(P>0.05).The sensitivity and specificity of serum Mycobacterium tuberculosis Hsp10 in the diagnosis of spinal tuberculosis were 81.40%and 70.83%,which were higher than 62.79%and 54.17%of the PPD test.There were no significant differences between CT andMRIinthedetection rates of bone intervertebral disc injury and paravertebral injury(P>0.05).The detection rates of dural cyst,spinal meningeal enhancement and ligament diffusion by MRI were significantly higherthanthosebyCT(P<0.05).The detection rate of calcification by CT was significantly higher than that by MRI(P<0.05).The sensitivity and specificity of MRI in the diagnosis of spinal tuberculosis were 93.02%and 87.50%,which were higher than 44.19%and 79.17%of the CT.Conclusion The level detection of serum Mycobacterium tuberculosis Hsp10 and MRI have certain diagnostic value for spinal tuberculosis.If combining Hsp10

关 键 词：结核杆菌热休克蛋白10 核磁共振 结核菌素试验 脊柱结核 

分 类 号：R529.2[医药卫生—内科学]