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一个临床预测模型,以区分结核性脊髓炎和自发性 pyogenic 脊髓炎
Thamrong Lertudomphonwanit1, Chirtwut Somboonprasert1,2, Kittiphon Lilakhunakon1,3
1Faculty of Medicine Ramathibodi Hospital, Department of Orthopaedics, Mahidol University, Bangkok, Thailand.
一个新的评分系统有效地区分了结核性脊髓炎 (TS) 和发烧性脊髓炎 (PS). 该工具使用临床因素,生物标志物如白细胞计数和MRI发现来预测TS概率.
科学领域:
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
- 生物标志物 生物标志物
背景情况:
- 结核性脊髓炎 (TS) 和发热性自发性脊髓炎 (PS) 的微生物学诊断存在诊断挑战.
- 区分TS和PS对于适当的治疗和患者管理至关重要.
研究的目的:
- 通过使用临床,放射学和生物标记数据,确定区分TS和PS的预测因素.
- 开发一个评分系统来分层TS的概率.
主要方法:
- 一个回顾性单中心研究分析了患者的人口统计学,临床特征,实验室发现和放射特征.
- 多变量逻辑回归确定了与TS相关的独立因素.
- 使用显著预测因素构建了一个评分方案.
主要成果:
- 在MRI上,TS与年龄较小,结核病史,症状持续时间较长,没有发烧,胸脊干干涉及和副脊柱有关.
- 较低的白细胞 (WBC) 计数,红细胞沉率 (ESR),中性粒细胞分数和C反应蛋白水平与TS有关.
- 对于TS的显著预测因素包括WBC ≤9,700/mm3,中性粒细胞分数 ≤78%,ESR ≤92 mm/hr,以及MRI上的副脊柱 (AUC=0.921).
结论:
- 结合WBC,中性粒细胞分数,ESR和副脊柱的预测模型准确地预测了致病原体.
- 开发的评分系统有效地将TS与PS区分开来,有助于临床决策.
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