Clinical Value Analysis Of C-Reactive Protein,Erythrocyte Sedimentation Rate,Procalcitonin,and Leukocyte Count For Spinal Tuberculosis

Objective : To investigate the diagnostic value of C-reactive protein,erythrocyte sedimentation rate and erythrocyte sedimentation rate,procalcitonin,and leukocyte count for spinal tuberculosis.Methods From 2015 to 2018,79 cases of spinal tuberculosis(group A),32 cases of suppurative spondylitis(group B),20 cases of spinal metastatic tumor(group C),osteoporosis compressibility 41 cases of fracture(for group D).The age,gender,course of disease,VAS score,C-reactive protein,erythrocyte sedimentation rate,total white blood cell count,procalcitonin were recorded in each group.The clinical data of the patients were combined and the characteristics of each group were analyzed.The area under the ROC curve was evaluated for each inflammatory index,and the sensitivity and specificity of each inflammatory index were calculated.The correlation between each inflammatory index and spinal tuberculosis was analyzed.The clinical data of 60 patients in groups A,B and C were randomly selected and randomly divided into two groups.Each group had 30 patients.One group of patients had complete clinical data including inflammation index,medical history and imaging examination.The group only had clinical data such as pathological signs and imaging examinations.The two groups of senior doctors diagnosed the two groups of patients and recorded the correct number of diagnoses.The diagnostic accuracy of the two groups was tested by t test.Results The average age of patients in each group was 54.5±8.3 years in group A,53.7±8.7 years in group B,45.2±8.5 years in group C,and 73.2±7.5 years in group D.The differences between the groups were statistically significant(P < 0.05).).There were 37 males and 42 females in group A,18 males and 14 females in group B,11 males and 9 females in group C,15 males and 26 females in group D.There were no gender differences between groups.Statistical significance(P <0.05).The mean duration of disease in the four groups was 42.7±21.4 days in group A,47.6±22.9 days in group B,32.1±7.1days in group C,and 6.1±3.1 days in group D.The longest course of disease was in group B,and the disease duration in group D was the shortest.The difference in duration of disease was statistically significant(P < 0.05).The WBC mean of the four groups A,B,C and D were7.69±4.27(×109 /L),9.75±3.29(×109 /L),6.74±2.0(×109 /L),6.64±1.90(×109)./L),the highest in group B and the lowest in group D,and the difference in WBC between groups was statistically significant(P<0.05).The ESR mean of A,B,C,and D are 64.37±30.69mm/h,84.56±26.45mm/h,43.00±26 mm/h,and 10.49±6.01mm/h,respectively,the highest in group B and the lowest in group D.The difference of ESR between the groups was statistically significant(P <0.05);the mean CRP of each group of A,B,C and D were 49.79±54.93mg/L,79.74±51.38mg/L,6.50±50.38mg/L The D group was 9.02±12.16mg/L,the highest in group B and the lowest in group D.The difference between groups was statistically significant(P <0.05);the mean PCT of group A,B,C and D was 0.20±0.27 ng respectively./ ml,0.44 ± 0.29 ng / ml,0.035± 0.21 ng / ml,0.03 ± 0.02 ng / ml,the highest in group B,the lowest in group D,the difference between the groups was statistically significant(P<0.05).The sensitivity of each inflammatory index WBC,ESR,CRP,PCT,and joint diagnosis were 0.442,0.671,0.937,0.316(min),and0.810(max),respectively.The specificity of each inflammatory index WBC,ESR,CRP,PCT and joint diagnosis were 0.810,0.712,0.308(min),1.000(max),and 0.673,respectively.The inflammatory markers WBC,ESR,CRP,PCT,and combined diagnosis of spinal tuberculosis under the ROC curve are all >0.5,so they have diagnostic value;AUC values of each group are 0.608,0.702,0.565(min),0.648,0.776(max).Correlation analysis showed a positive correlation between ESR,CRP,and PCT and spinal tuberculosis diagnosis.There was no significant correlation between WBC and spinal tuberculosis.Conclusion CRP and PCT are of certain clinical value in the early diagnosis of spinal tuberculosis and for distinguishing spine metastatic tumors.ESR has a certain value in the diagnosis of spinal tuberculosis without obvious value for differenciating diagnosis of suppurative spondylitis.