General Hospital of Tianjin Medical University, 300052, China; Department of Orthopedics, Tianjin Haihe Hospital, China.
General Hospital of Tianjin Medical University, 300052, China.
Int J Surg. 2017 Aug;44:99-103. doi: 10.1016/j.ijsu.2017.05.077. Epub 2017 Jun 16.
To investigate the effect of vitamin D deficiency on susceptibility to spinal tuberculosis and its pathological development.
A case-control design was used in this study. A total of 163 treatment-naïve patients with spinal tuberculosis admitted to this institute for an operation from June 2013 to May 2016 were included in the case group, and 170 subjects who received a health examination in the same hospital were included in the control group. Control group patients were frequency-matched with the case group by age, gender, and season. Serum 25-hydroxyvitamin D levels were detected using an enzyme linked immunosorbent assay (ELISA). Pathological classification of patients in the case group was conducted according to intraoperative findings, and definite diagnosis of spinal tuberculosis was confirmed after operation.
The serum level of vitamin D [23.99 (20.55, 29.54) nmol/L] in the case group was lower than that in the control group [42.94 (35.68, 51.04) nmol/L], and the difference was statistically significant (Z = -9.048, P < 0.05). Out of the 163 patients with spinal tuberculosis who underwent pathological classification, 107 cases of caseous necrosis and 56 cases of hyperplasia were identified. Based on the vitamin D levels of the patients in the case group, these patients were further divided into a low-level group (<25 nmol/L) and a high-level group (≥25 nmol/L). The proportion of patients with caseous necrosis in the low-level group (79.17%) was higher than that in the high-level group (46.27%), with a statistically significant difference (χ = 18.937, P < 0.05).
Vitamin D deficiency is associated with susceptibility to spinal tuberculosis and its pathological classification, and vitamin D deficiency affects the occurrence and development of spinal tuberculosis.
探讨维生素 D 缺乏对脊柱结核易感性及其病理发展的影响。
采用病例对照设计，选取 2013 年 6 月至 2016 年 5 月在本院接受手术治疗的 163 例未经治疗的脊柱结核患者为病例组，同期在本院体检的 170 例健康者为对照组。对照组患者按年龄、性别、季节与病例组进行频数匹配。采用酶联免疫吸附试验（ELISA）检测血清 25-羟维生素 D 水平。根据术中所见对病例组患者进行病理学分类，术后明确诊断为脊柱结核。
病例组血清维生素 D 水平[23.99（20.55，29.54）nmol/L]低于对照组[42.94（35.68，51.04）nmol/L]，差异有统计学意义（Z=-9.048，P<0.05）。163 例脊柱结核患者经病理学分类，其中干酪样坏死 107 例，增生 56 例。根据病例组患者的维生素 D 水平，将其进一步分为低水平组（<25 nmol/L）和高水平组（≥25 nmol/L）。低水平组患者中干酪样坏死比例（79.17%）高于高水平组（46.27%），差异有统计学意义（χ²=18.937，P<0.05）。
维生素 D 缺乏与脊柱结核易感性及其病理学分类有关，维生素 D 缺乏影响脊柱结核的发生和发展。
