Department of Orthopaedic Surgery, RWTH Aachen, Aachen, Federal Republic of Germany.
Eur Spine J. 1992 Dec;1(3):152-5. doi: 10.1007/BF00301305.
Even today a significant feature of spondylodiscitis is the long interval between the onset of symptoms and the establishment of the diagnosis (on average 6.4 months in our study). In order to improve early detection of spinal infections, new markers of inflammation were determined in patients with spondylodiscitis. Neopterin is produced by macrophages after their activation by T-lymphocytes, polymorphonuclear neutrophil (PMN) elastase is set free by activated granulocytes. Erythrocyte sediment rate (ESR) showed the highest sensitivity of all determined inflammation markers, but reached only a poor diagnostic specificity. The sensitivity of the white blood cell count was poor. C-reactive protein (CRP) and neopterin reached a sensitivity of 75% each in spondylodiscitis and had a good diagnostic specifity. Sensitivity of PMN elastase reached 67%. Contrary to ESR the new inflammation markers were also helpful in the following up of treated spondylodiscitis. PMN elastase showed quickest normalization of all inflammation parameters. For early detection of spondylodiscitis and clinical follow up we recommed combined determinations of CRP, neopterin and PMN elastase.
即使在今天，脊椎炎的一个显著特征是症状出现和诊断确立之间的时间间隔很长（在我们的研究中平均为 6.4 个月）。为了提高脊柱感染的早期检测，我们在脊椎炎患者中确定了新的炎症标志物。Neopterin 是 T 淋巴细胞激活巨噬细胞后产生的，多形核中性粒细胞 (PMN) 弹性蛋白酶由活化的粒细胞释放。红细胞沉降率 (ESR) 在所有确定的炎症标志物中显示出最高的敏感性，但仅达到较差的诊断特异性。白细胞计数的敏感性较差。CRP 和 Neopterin 在脊椎炎中分别达到 75%的敏感性，具有良好的诊断特异性。PMN 弹性蛋白酶的敏感性为 67%。与 ESR 相反，新的炎症标志物在治疗后的脊椎炎随访中也有帮助。PMN 弹性蛋白酶是所有炎症参数中最快恢复正常的。为了早期发现脊椎炎并进行临床随访，我们建议联合测定 CRP、Neopterin 和 PMN 弹性蛋白酶。
