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目的 探讨脊柱手术前后红细胞沉降率(ESR)和C反应蛋白(CRP)动态变化及其临床意义.方法 测量60例脊柱手术患者术前、术后每天的CRP和ESR,记录术后所有合并感染患者的ESR、CRP.结果 8例患者术后发生感染,术后77%患者出现CRP峰值,47%患者出现ESR峰值.多元回归分析确定具有统计学差异的预测术后更高峰值的因素有术前CRP水平、椎体固定数和脊柱手术部位(P<0.01),峰值后CRP半衰期为2.6(P<0.01),ESR没有该趋势.峰值后4 d,CRP预测术后感染并发症的敏感性、特异性、阳性预测值(PPV)及阴性预测值(NPV)分别为81%、46%、43%和87%.结论 术后早期检测CRP具有实用性、敏感性和预测性,较ESR更有诊断价值,其第二次升高或不降可作为诊断感染的敏感指标.“,”Objective To study the change and linical significance of C-reactive protein(CRP) level and erythrocyte sedimentation rate(ESR) before and after spinal surgery. Methods ESR and CRP were measured daily before and after surgery in 60 spinal patients. Infectious complications were recorded. Results Infectious complications occurred in 8 patients, in whom a postoperative peak was observed in 77% for CRP and in 47% for ESR. Multiple linear regression analysis revealed that preoperative CRP, number of levels and lumbar region were the significant predictors of greater CRP peak value (P<0. 01). After the peak, CRP showed an ponential decrease with a half-life time of 2. 6 days (P<0. 01), which was not for ESR. The sensitivity, specificity, positive predictive value, and negative predictive value predicted by CRP 4 days after the peak were 81%, 46%, 43%, and 87% for infectious complications, respectively. Conclusion CRP is more applicable, predictable, and responsive than ESR in the early postoperative period. The second rise or failure to decrease as expected by CRP is a sensitive indicator for predicting postoperative infection.