热休克蛋白10联合MRI对胸腰椎体结核的诊断价值  

Diagnostic value of heat shock protein 10 combined with MRI in thoracolumbar spinal tuberculosis

作　　者：郁雯 胡晶晶 黄碧红 李浩雄 劳杰 YU Wen;HU Jing-jing;HUANG Bi-hong;LI Hao-xiong;LAO Jie(Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院手外科,上海200040 [2]复旦大学附属华山医院放射科,上海200040

出　　处：《中华医院感染学杂志》2024年第12期1836-1840,共5页Chinese Journal of Nosocomiology

基　　金：上海市临床重点专科基金资助项目(shslczdzk05601)。

摘　　要：目的探讨结核分枝杆菌热休克蛋白10(Hsp10)联合磁共振成像(MRI)对胸腰椎体结核的诊断价值.方法选取2013年1月-2021年5月就诊的95例疑似胸腰椎体结核的患者,行血清结核分枝杆菌Hsp10检测和MRI检查,将病理检查确诊为胸腰椎体结核76例设为结核组、脊柱转移瘤19例设为转移瘤组;比较两组血清结核分枝杆菌Hsp10水平、MRI时间信号曲线特征、容积转运常数(Ktrans)、速率常数(Kep),分析其诊断价值.结果结核组的血清结核分枝杆菌Hsp10水平高于转移瘤组(P<0.05);结核组MRI时间信号曲线:持续上升型占44.74%,上升平台型占48.68%,快进快出型占6.58%;转移瘤组MRI时间信号曲线:持续上升型占21.05%,上升平台型占31.58%,快进快出型占47.37%,两组MRI时间信号曲线差异有统计学意义(P<0.05);结核组的Ktrans、Kep均小于转移瘤组(P<0.05);血清结核分枝杆菌Hsp10的Kappa值为0.573,准确率为85.26%.MRI的Kappa值为0.731,准确率为90.53%.MRI联合血清结核分枝杆菌Hsp10的Kappa值为0.817,准确率为93.68%.结论Hsp10联合MRI可提高胸腰椎体结核的诊断准确率.OBJECTIVE To investigate the diagnostic value of Mycobacterium tuberculosis heat shock protein 10(Hsplo)combined with magnetic resonance imaging(MRI)in thoracolumbar spinal tuberculosis.METHODS A total of 95 patients with suspected thoracolumbar tuberculosis who attended the clinic between Jan.2013 and May 2021 were selected and underwent serum Mycobacterium tuberculosis Hsp10 detection and MRI examination.76 cases of thoracolumbar tuberculosis confirmed by pathological examination were set up as the tuberculous group,and 19 cases of spinal metastasis were set up as the metastasis group.Serum Mycobacterium tuberculosis Hspl0 levels,time-signal curve characteristics of MRI,volume transfer constant(Ktrans),and rate constants(Kep)were compared between the two groups,and their diagnostic value was analyzed.RESULTS Serum Mycobacterium tuberculosis Hsplo level in the tuberculosis group was higher than that in the metastasis group(P<0.05).The MRI time-signal curves of the tuberculosis group were:44.74%of the continuously ascending type,48.68%of the ascending plateau type,and 6.58%of the fast-entry-fast-exit type;the MRI time-signal curves in the metastasis group were 21.05%of the continuously ascending type,31.58%of the ascending plateau type,and 47.37%of the fast-entry-fast-exit type,with statistically significant differences between the two groups(P<0.05).The Ktrans and Kep in the tuberculosis group were lower than those in the metastasis group(P<0.05).The Kappa value of serum Mycobacterium tuberculosis Hspl0 were 0.573,with an accuracy rate of 85.26%.The Kappa value of MRI were 0.731,with an accuracy rate of 90.53%.The Kappa value of MRI combined with serum Mycobacterium tuberculosis Hspl0 were 0.817,with an accuracy rate of 93.68%.CONCLUSION Hspl0 combined with MRI could improve the diagnostic accuracy for thoracolumbar spinal tuberculosis.

关 键 词：磁共振成像 热休克蛋白10 胸腰椎体 结核分枝杆菌 诊断 

分 类 号：R825.2[医药卫生—临床医学]