Variety Of High Sensitive-C Reactive Protein And Erythrocyte Sedimentation Rate In The Treatment Of Spinal Tuberculosis

Objective To investigate the variety of high sensitive–C Reactive Protein(hs–CRP) and Erythrocyte Sedimentation Rate (ESR) in the diagnosis and treatment of spinal tuberculosis ; To investigate the variety's clinical value . To contrast the sensitivity of high sensitive–C Reactive Protein and erythrocyte Sedimentation Rate ; To investigate the common causes of the exceptional variations hs–CRP and ESR appeared after patients'operation .Methods 268 cases of patients with spinal tuberculosis who received operations in the Affiliated Hospital of Ningxia Medical University from November 1998 to March 2010 were collected . Chose the following observation time points : before the chemotherapy , 1 week , 2 weeks and 3 weeks after the chemotherapy , 1 week , 2 weeks , 3 weeks , 1 month , 2 months , 3 months , 4 months , 5 months , 6 months , 1 year , 2 years and 3 years after operation . Observed the average value of hs–CRP and ESR and the abnormal rate of hs–CRP and ESR . Observed the variety of hs–CRP and ESR after the chemotherapy and the variety of hs–CRP and ESR after patients'operation . Made a statistic analysis at last . Analyzed the common causes of the exceptional variations hs–CRP and ESR appeared after patients'operation .Results 1. After one week chemotherapy , the average value of hs–CRP 25.62 mg/L and the average value of ESR 44.57 mm/h increased statistically (P<0.05) , compared with the average value of hs–CRP 17.46 mg/L and the average value of ESR 37.44 mm/h before chemotherapy . After two weeks and three weeks chemotherapy , the average value of hs–CRP 23.82 mg/L , 17.78 mg/L and the average value of ESR 43.54 mm/h , 37.91 mm/h did not increase statistically , compared with the average value before chemotherapy . 2. After one week , two weeks and three weeks chemotherapy , the abnormal rate of hs–CRP 89 % , 87 % , 87 % and the abnormal rate of ESR 85 % , 79 % , 77 % did not increase statistically , compared with the abnormal rate of hs–CRP 84 % and the abnormal rate of ESR 75 % before chemotherapy . 3. One week after operation , the average value of hs–CRP 36.41 mg/L and the abnormal rate of hs–CRP 95 % increased statistically (P<0.05) , compared with the average value of hs–CRP 17.78 mg/L and the abnormal rate of hs–CRP 87 % before operation . Two weeks and three weeks after operation , the average value of hs–CRP 18.78 mg/L , 17.50 mg/L and the abnormal rate of hs–CRP 86 % , 86 % did not increase statistically , compared with the average value and the abnormal rate before operation . 4. One week and two weeks after operation , the average value of ESR 57.57 mm/h , 49.82 mm/h and the abnormal rate of ESR 92 % , 88 % increased statistically (P<0.05) , compared with the average value of ESR 37.91 mm/h and the abnormal rate of ESR 77 % before operation . Three weeks after operation , the average value of ESR 42.58 mm/h and the abnormal rate of ESR 83 % did not increase statistically , compared with the average value and the abnormal rate before operation . 5. One month after operation , the average value of hs–CRP 11.45 mg/L , the abnormal rate of hs–CRP 64 % , the average value of ESR 25.58 mm/h and the abnormal rate of ESR 52 % declined statistically (P<0.05) , compared with the average value and the abnormal rate before operation . Two months after operation , the average value of hs–CRP 3.27 mg/L , the abnormal rate of hs–CRP 27 % , the average value of ESR 12.96 mm/h and the abnormal rate of ESR 20 % declined statistically (P<0.05) , compared with the average value and the abnormal rate one month after operation . Three months after operation , the average value of hs–CRP is 2.13 mg/L , the abnormal rate of hs–CRP is 18 % , the average value of ESR is 9.58 mm/h and the abnormal rate of ESR is 16 % . Four months after operation , the average value of hs–CRP is 2.14 mg/L , the abnormal rate of hs–CRP is 6 % , the average value of ESR is 9.59 mm/h and the abnormal rate of ESR is 5 % . 7. Hs–CRP and ESR varied exceptionally in 20 patients after operation . It means that one month after operation , the value of hs–CRP and ESR increased . Within the 20 patients , there were 15 patients with cold abscess 75% , 2 patients with other organic tuberculosis 10% , 1 patient with liver injury caused by chemotherapy 5% , 1 patient with renal insufficiency 5% , 1 patient with other organic infection caused by bacteria 5% .Conclusion 1. After one week , two weeks and three weeks chemotherapy , the average value and the abnormal rate of hs–CRP , ESR did not decline statistically , compared with the average value and the abnormal rate before chemotherapy . It is improper to choose timing of surgery only according to hs–CRP and ESR .2. In the early days after operation , the average value and the abnormal rate of hs–CRP and ESR increased statistically . Hs–CRP declined earlier than ESR after operation . Hs–CRP is more sensitive than ESR .3. One month after operation , the average value and the abnormal rate of hs–CRP , ESR declined statistically , compared with the average value and the abnormal rate before operation . Two months after operation , the average test value and the abnormal rate of hs–CRP , ESR declined statistically , compared with the average value and the abnormal rate one month after operation . Four months after operation , most of the patients had normal hs–CRP and ESR .4. The most common cause of the exceptional variation hs–CRP and ESR appears after operation was cold abscess .