Gebhardt Katja, Brenner Hermann, Stürmer Til, Raum Elke, Richter Wiltrud, Schiltenwolf Marcus, Buchner Matthias
Orthopaedic Clinic at the University of Heidelberg, Schlierbacher Landstrasse 200a, D-69118 Heidelberg, Germany.
Eur J Pain. 2006 Nov;10(8):711-9. doi: 10.1016/j.ejpain.2005.11.005. Epub 2006 Jan 5.
In this prospective longitudinal study with a follow-up of 6 months, the course of serum concentration of C-reactive protein was measured by an ultrasensitive immunoassay in 31 patients with acute lumbosciatic pain and 41 patients with chronic low back pain. High-sensitive CRP (hsCRP), pain and clinical function were assessed at ten fixed time-points during follow-up. The course of hsCRP values was assessed in relation to the course of pain and clinical function adjusting for possible confounding factors. At the beginning of the study, there were no statistically significant differences in mean hsCRP levels in patients with acute lumbosciatic pain (1.49mg/l) compared to the levels obtained in patients with chronic low back pain (1.30mg/l) and those in a control group from the general population (1.26mg/l). In patients with acute lumbosciatic pain, hsCRP declined significantly in the initial period of 3 weeks with a corresponding decrease in pain and improvement in function and clinical evaluation as assessed with the straight leg raising test (SLR), whereas after this period, the course of the hsCRP did not correspond with the clinical parameters. In patients with chronic low back pain, hsCRP remained approximately constant throughout the whole period with no correlation with pain or function. As a conclusion, according to this study levels of hsCRP do not have a major clinical relevance when evaluating the long-term course of patients with acute lumbosciatic pain and chronic low back pain and therefore should not be taken into primary consideration when decisions on therapy are made.
在这项为期6个月随访的前瞻性纵向研究中，通过超敏免疫测定法测量了31例急性腰骶部疼痛患者和41例慢性下腰痛患者血清C反应蛋白浓度的变化过程。在随访期间的10个固定时间点评估了高敏CRP（hsCRP）、疼痛和临床功能。根据疼痛和临床功能的变化过程评估hsCRP值的变化过程，并对可能的混杂因素进行校正。在研究开始时，急性腰骶部疼痛患者的平均hsCRP水平（1.49mg/l）与慢性下腰痛患者（1.30mg/l）以及普通人群对照组（1.26mg/l）相比，无统计学显著差异。在急性腰骶部疼痛患者中，hsCRP在最初3周内显著下降，同时疼痛相应减轻，功能和临床评估（通过直腿抬高试验（SLR）评估）有所改善，而在此之后，hsCRP的变化过程与临床参数不相符。在慢性下腰痛患者中，hsCRP在整个期间大致保持恒定，与疼痛或功能无关。总之，根据本研究，在评估急性腰骶部疼痛和慢性下腰痛患者的长期病程时，hsCRP水平没有主要的临床相关性，因此在做出治疗决策时不应将其作为首要考虑因素。
