基于红细胞沉降率和白细胞计数与病程构建化脓性与非化脓性脊柱感染的鉴别诊断模型  

Construction of a differential diagnostic model for pyogenic and non-pyogenic spinal infections based on erythrocyte sedimentation rate and white blood cell with disease duration

作　　者：张呈冉 胡小江 张广 唐博 徐东宬 高琪乐[1,2] 唐明星[1,2] 刘少华[1,2] ZHANG Cheng-ran;HU Xiao-jiang;ZHANG Guang;TANG Bo;XU Dong-cheng;GAO Qi-le;TANG Ming-xing;LIU Shao-hua(Xiangya Hospital,Central South University,Xiangya,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院骨科脊柱外科,湖南长沙410008 [2]中南大学湘雅医院国家老年疾病临床医学研究中心,湖南长沙410008

出　　处：《中华医院感染学杂志》2024年第12期1831-1835,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(82072460、82170901);湖南省自然科学基金资助项目(2020J4892、2020JJ4908)。

摘　　要：目的构建基于C-反应蛋白、红细胞沉降率及血常规指标等构建化脓性脊柱感染(PSI)和非化脓性脊柱感染(NPSI)的鉴别诊断模型.方法收集2019年1月-2022年9月湘雅医院及湘雅博爱医院收治的疑似脊柱感染患者158例为研究对象,根据病理鉴定结果分为PSI组(87例)和非PSI组(71例);分析两组临床资料,比较两组各指标的差异;筛选出C-反应蛋白、红细胞沉降率与病程并得出诊断模型,绘制受试者工作特征(ROC)曲线,评估模型的诊断价值.结果两组C-反应蛋白、红细胞沉降率、白细胞计数、红细胞计数、血红蛋白、中性粒细胞、中性粒细胞百分比、单核细胞百分比及病程差异有统计学意义(P<0.05);通过Logistic回归,筛选出红细胞沉降率、白细胞计数、病程三项指标建立联合诊断模型,该模型ROC曲线下的面积(AUC)为0.802,敏感度为0.678,特异度为0.845.结论通过红细胞沉降率,白细胞计数,病程三项指标建立的联合诊断模型,能辅助鉴别化脓性与非化脓性脊柱感染,可更好地指导临床,及时开展针对性治疗改善患者预后.OBJECTIVE To construct a differential diagnostic model for pyogenic spinal infection(PSI)and non-pyogenic spinal infection(NPSI)based on C-reactive protein,erythrocyte sedimentation rate,and blood routine indicators.METHODS Totally 158 suspected spinal infection patients admitted to Xiangya and Xiangya Boai Hospital from Jan.2019 to Sep.2022 were collected as the study subjects,and they were divided into a PSI group(87 cases)and a non PSI group(71 cases)according to pathological identification results.Clinical data of the two groups were analyzed,and the differences in various indicators between the two groups were compared.C-reactive protein,erythrocyte sedimentation rate,and disease course were screened to develop a diagnostic model,receiver operating characteristic(ROC)curves were plotted to evaluated the diagnostic value of the model.RESULTS There were statistically significant differences in C-reactive protein,erythrocyte sedimentation rate,white blood cell count,red blood cell count,hemoglobin,neutrophils,neutrophil percentage,monocyte percentage,and disease course between the two groups(P<0.05);Through logistic regression,the three indicators of red blood cell sedimentation rate,white blood cell count,and disease course were screened to establish a joint diagnostic model,which had an area under the ROC curve(AUC)of 0.802,a sensitivity of 0.678,and a specificity of 0.845.CONCLUSION The joint diagnostic model established by red blood cell sedimentation rate,white blood cell count,and disease course can assist in differentiating pyogenic and non-pyogenic spinal infections,which can better guide the clinic and improve the prognosis of patients with timely and targeted treatment.

关 键 词：化脓性脊柱感染 C-反应蛋白 血沉 病程 诊断价值 

分 类 号：R681.5[医药卫生—骨科学]