降钙素原水平与髋关节结核病变严重程度及预后的相关性研究  

Correlation of procalcitonin level with the severity and prognosis of hip joint tuberculosis

作　　者：张鹏[1] 张迪[1] 李向科 韩永台[2] 申勇[1] ZHANG Peng;ZHANG Di;LI Xiang-ke;HAN Yong-tai;SHEN Yong(Department of Spine Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China;Department of Bone Disease, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China)

机构地区：[1]河北医科大学第三医院脊柱外科,河北石家庄050051 [2]河北医科大学第三医院骨病科,河北石家庄050051

出　　处：《河北医科大学学报》2020年第4期405-408,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题计划(20160148)。

摘　　要：目的探讨髋关节结核患者降钙素原(procalcitonin,PCT)水平与关节病变严重程度及在判断疾病预后中的价值。方法回顾性分析166例髋关节结核患者的临床资料。根据Babhulkar髋关节结核分期标准将患者分成4组:A组(Ⅰ期,滑膜炎期)58例;B组(Ⅱ期,早期关节炎期)51例;C组(Ⅲ期,关节炎期)33例;D组(Ⅳ期,晚期关节炎期)24例。对A、B组患者采用口服抗结核药物治疗,对C、D组患者采取手术及抗结核药物治疗,观察并比较不同时间点各组PCT变化情况,以视觉模拟评分(Visual Analogue Score,VAS)及髋关节Harris评分来评价疼痛和髋关节功能恢复情况。结果随着病变程度的逐步加重,PCT浓度及VAS评分均逐步增高,Harris评分逐步降低,组间比较差异有统计学意义(P<0.05)。从抗结核药物治疗2周到手术治疗1年后,4组患者的PCT浓度下降幅度、VAS评分及Harris评分变化明显,差异有统计学意义。结论髋关节结核患者,关节病变严重程度与PCT水平相关;抗结核药物可以降低PCT水平,但手术治疗后的PCT下降速度更快,髋部疼痛缓解更好,且髋关节功能恢复更优。Objective To investigate the correlation of procalcitonin(PCT)level with the severity of hip joint tuberculosis and its value in predicting the prognosis.Methods The clinical data of 166 patients with tuberculosis of hip joint were analyzed retrospectively.According to babhulkar's criteria,the patients were divided into four groups:group A(stageⅠ,synovitis stage),58 cases;group B(stageⅡ,early arthritis stage),51 cases;group C(stageⅢ,arthritis stage),33 cases;group D(stageⅣ,late arthritis stage),24 cases.Patients in groups A and B were treated with oral anti-tuberculosis drugs,and patients in groups C and D were treated with surgery and anti-tuberculosis drugs.The changes of PCT in each group at different time points was observed and compared.The visual analog scale(VAS)was used to evaluate the pain and the Harris score was used to evaluate hip function.Results With the gradual aggravation of the lesion,the PCT concentration and VAS score gradually increased,and the Harris score gradually decreased,and the difference between the groups was statistically significant(P<0.05).From 2 weeks of anti-tuberculosis drug treatment to 1 year after surgical treatment,the PCT concentration,VAS score and Harris score of the 4 groups of patients changed significantly,the difference was statistically significant.Conclusion In patients with tuberculosis of hip joint,the severity of joint disease is positively related to the level of PCT.Antituberculous drugs can reduce the level of PCT,but after surgery,PCT decreases faster,hip pain relief is better,and hip function recovery is better.

关 键 词：结核 骨关节 髋关节 降钙素原 

分 类 号：R529.2[医药卫生—内科学]