摘要
目的:探讨联合检测血清C-反应蛋白(CRP)、红细胞沉降率(ESR)、血小板计数(PC)、血小板计数/平均血小板体积(PC/MPV)和血小板压积(PCT)对诊断慢性关节假体周围感染(PJI)的价值。方法:回顾性分析2013年1月至2019年12月期间在新疆医科大学第一附属医院行人工髋、膝关节翻修术的441例患者资料。根据病种不同分为慢性PJI组和假体无菌性松动组。慢性PJI组147例(髋86例,膝61例),男64例,女83例;中位年龄为66(54,72)岁。假体无菌性松动组294例(髋210例,膝84例),男98例,女196例;中位年龄为63(49,72)岁。比较两组患者的术前CRP、ESR、PC、PC/MPV和PCT水平,记录上述指标诊断慢性PJI的最佳截断值、敏感度及特异度。通过比较各项指标的曲线下面积(AUC)及联合诊断试验分析结果来评价5种指标的组合对慢性PJI的诊断效能。结果:两组患者除性别、关节翻修部位外,其他一般资料比较差异均无统计学意义(P>0.05),具有可比性。慢性PJI组患者的CRP、ESR、PC、PC/MPV和PCT水平显著高于假体无菌性松动组患者,差异均有统计学意义(P<0.05)。CRP、ESR、PC、PC/MPV和PCT诊断慢性PJI的最佳截断值分别为:9.05 mg/L、38.5 mm/h、288×109/L、29.34、0.33%,敏感度分别为83%、71%、44%、44%、33%,特异度分别为85%、86%、84%、84%、90%,AUC分别为0.868、0.822、0.688、0.696、0.659。CRP+ESR+PC+PC/MPV+PCT、CRP+PC+PC/MPV+PCT的AUC分别为0.871、0.882,敏感度分别为80%、84%,特异度分别为86%、84%;与ESR、PC、PC/MPV和PCT单独诊断慢性PJI的AUC比较差异均有统计学意义(P<0.05)。结论:血清CRP、ESR联合PC、PC/MPV及PCT对慢性PJI的诊断具有参考价值,但PC、PC/MPV及PCT单独诊断慢性PJI的价值有限。
Objective To investigate the values of combined detection of serum C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),platelet count(PC),platelet count/mean platelet volume(PC/MPV)and platelet plateletcrit(PCT)in the diagnosis of chronic periprosthetic joint infection(PJI).Methods From January 2013 to December 2019,441 patients underwent hip or knee joint revision at Department of Articular Surgery,The First Hospital Affiliated to Xinjiang Medical University.The patients were divided into a chronic PJI group and an aseptic prosthetic loosening group.In the chronic PJI group of 147 cases(86 hip ones and 61 knee ones),there were 64 males and 83 females,with a mean age of 66(54,72)years.In the aseptic prosthetic loosening group of 294 cases(210 hip ones and 84 knee ones),there were 98 males and 196 females,with a mean age of 63(49,72)years.The preoperative levels of CRP,ESR,PC,PC/MPV and PCT were compared between the 2 groups.The best cut-off value,sensitivity and specificity of the above indicators for the diagnosis of chronic PJI were recorded.The diagnostic efficacy of the 5 indicators in combination for chronic PJI was evaluated by comparing the area under the curve(AUC)among the indicators and analyzing the results of combined diagnostic detections.Results Except for gender and joint revision site,there was no significant difference in the other general data between the 2 groups,showing comparability(P>0.05).The levels of CRP,ESR,PC,PC/MPV and PCT in the PJI group were significantly higher than those in the aseptic prosthetic loosening group(P<0.05).For CRP,ESR,PC,PC/MPV and PCT,respectively,the best cut-off values were 9.05 mg/L,38.5 mm/h,288×109/L,29.34 and 0.33%,the sensitivities 83%,71%,44%,44%and 33%,the specificities 85%,86%,84%,84%and 90%,and the AUCs 0.868,0.822,0.688,0.696 and 0.659.For CRP+ESR+PC+PC/MPV+PCT and CRP+PC+PC/MPV+PCT,respectively,the AUCs were 0.871 and 0.882,the sensitivities 80%and 84%,and the specificities 86%and 84%,showing significant differences in the diagnosis of chronic
作者
田帅飞
郭晓斌
李亦丞
张晓岗
曹力
Tian Shuaifei;Guo Xiaobin;Li Yicheng;Zhang Xiaogang;Cao Li(Department of Articular Surgery,The First Hospital Affiliated to Xinjiang Medical University,Urumqi 830054,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第9期786-792,共7页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学基金(82072487,82002276)
新疆维吾尔自治区自然科学基金(2020D01C263)。
关键词
关节成形术
置换
髋
关节成形术
置换
膝
C反应蛋白质
红细胞沉降率
假体相关感染
血小板计数
平均血小板体积
Arthroplasty,replacement,hip
Arthroplasty,replacement,knee
C-reactive protein
Erythrocyte sedimentation rate
Prosthesis-related infections
Platelet count
Mean platelet volume
