ESR、白细胞计数与CRP联合检测在老年膝关节炎临床诊断中的应用价值  

Application Value of ESR,White Blood Cell Count and CRP in Clinical Diagnosis of Senile Knee Arthritis

作　　者：陈锦[1] 杜懿 Chen Jin(Department of Laboratory Medicine,Lianjiang People’s Hospital,Lianjiang Guangdong 524400)

机构地区：[1]廉江市人民医院检验科,广东廉江524400

出　　处：《黑龙江医药》2024年第6期1300-1303,共4页Heilongjiang Medicine journal

基　　金：广东省医学科学技术研究基金项目(项目编号:B2024315)。

摘　　要：目的:探究血沉(ESR)、白细胞计数(WBC)与C反应蛋白(CRP)联合检测在老年膝关节骨性关节炎(KOA)临床诊断中的应用价值。方法:收集2023年1月至2024年7月在我院接受诊疗的老年KOA患者105例,作为试验组对象。同期收集在我院接受健康检查的志愿者45例,作为参照组对象。均接受ESR、WBC及CRP三项指标检测,试验组患者采用Kellgren-Lawrence(K-L)分级,其中1级与2级为轻度组、3级为中度组、4级为重度组。比较两组ESR、WBC及CRP三项指标水平;比较不同严重程度患者ESR、WBC及CRP三项指标水平;使用ROC曲线分析ESR、WBC及CRP单一与联合检测的诊断效能。结果:相比参照组志愿者,试验组患者的ESR、WBC及CRP水平均显著较高(P<0.05)。相比轻度组,中度组、重度组ESR、WBC及CRP水平均较高,且重度组ESR、WBC及CRP水平较中度组高(P<0.05)。当WBC≥10.55×10^(9)/L时,其诊断敏感度为80.18%、特异度为58.97%;当ESR≥22.15mm/h时,其诊断敏感度为76.03%、特异度为55.17%;当CRP≥15.17mg/L时,其诊断敏感度为88.07%、特异度为78.05%。经ESR、WBC及CRP联合诊断的AUC为0.928,其诊断敏感度为97.14%、特异度为93.33%。结论:老年KOA患者ESR、WBC及CRP三项指标水平较高,且3项指标联合检测老年KOA的诊断效能较高,推测ESR、WBC及CRP三项指标可作为基层诊断老年KOA的辅助性可靠指标。Objective:To explore the value of combined detection of erythrocyte sedimentation rate(ESR),white blood cell count(WBC)and C-reactive protein(CRP)in the clinical diagnosis of elderly knee osteoarthritis(KOA).Methods:105 elderly patients with KOA who received treatment in our department of Orthopedics from January 2023 to July 2024 were collected as experimental subjects.In the same period,45 volunteers who received health examination in our hospital were collected as the reference group.ESR,WBC and CRP were all tested.Kellgren-Lawrence(K-L)grades were applied to test group,with grade 1 and 2 as mild group,grade 3 as moderate group,and grade 4 as severe group.The levels of ESR,WBC and CRP were compared between the two groups.The levels of ESR,WBC and CRP in patients with different severity were compared.The diagnostic efficiency of ESR,WBC and CRP was analyzed by ROC curve.Results:Compared with the control group,the levels of ESR,WBC and CRP in experimental group were significantly higher(P<0.05).Compared with mild group,ESR,WBC and CRP levels in moderate and severe group were higher,and ESR,WBC and CRP levels in severe group were higher than those in moderate group(P<0.05).When WBC≥10.55×10^(9)/L,the diagnostic sensitivity was 80.18%and the specificity was 58.97%.When ESR≥22.15mm/h,the diagnostic sensitivity was 76.03%and the specificity was 55.17%.When CRP≥15.17mg/L,the diagnostic sensitivity was 88.07%and the specificity was 78.05%.The AUC of ESR,WBC and CRP combined diagnosis was 0.928,the diagnostic sensitivity was 97.14%,and the specificity was 93.33%.Conclusion:The levels of ESR,WBC and CRP in elderly patients with KOA are higher,and the combined detection of these three indicators has a higher diagnostic efficacy.It is speculated that ESR,WBC and CRP can be used as auxiliary and reliable indicators for the primary diagnosis of KOA in elderly patients.

关 键 词：血沉 白细胞计数 C反应蛋白 老年膝关节炎 诊断效能 

分 类 号：R593.22[医药卫生—内科学]