摘要
目的:探讨降钙素原在人工关节置换术后晚期感染中的预测价值,为人工关节置换术后假体周围晚期感染诊断提供理论参考依据。方法:回顾2015年1月至2017年12月进行人工关节翻修的患者77例,根据《假体周围感染国际共识》的诊断标准,分为人工关节置换术后感染组和非感染组,其中感染性翻修组21例,男7例,女14例,年龄(60.70±8.75)岁;非感染性翻修组56例,男24例,女32例,年龄(64.40±12.14)岁。比较2组人工关节翻修术前血清降钙素原阳性率。结果:感染性翻修组降钙素原阳性2例,分别为0.06 ng/L和0.10 ng/L;非感染性翻修组降钙素原阳性4例,分别为0.05、0.06、0.06、0.16 ng/L;两组比较,差异无统计学意义(P=0.662)。结论:人工关节置换术后晚期感染多属于低毒性感染,全身系统性炎症反应小,故关节局部感染不会引起降钙素原升高,除非局部感染变成系统性感染,因此降钙素原对人工关节置换术后的临床意义不大。但本研究回顾病例少,需要更多的样本进一步研究。
Objective:To study the predictive value of procalcitonin as a serum biomarker in diagnosis of late periprosthetic joint infection(PJI)for providing theoretical reference basis for diagnosis of PJI.Methods:A total of 77 cases were retrospective included from January 2015 to December 2017 for revision of total hip arthroplasty and total knee arthroplasty,according to the diagnostic criteria of Musculoskeletal Infection Society(MISI).All cases were divided into infection group and non infection group.Infection group included 21 cases,7 cases for male and 14 cases for female,with an average age of(60.70±8.75)years old(ranged 43 to 75 years old).Non infection group 56 included cases,24 cases for male and 32 cases for female,with an average age(64.40±12.14)years old(ranged 43 to 85 years old).Concentration of preoperative serum procalcitonin was examined and the chi square test was used to compare positive rate between the two groups.Results:Two cases in the infection group had positive serum procalcitonin,0.06 ng/L and 0.10 ng/L respectively,with the positive rate of 9.52%;4 cases in non infected group had positive serum procalcitonin,0.05 ng/L,0.06 ng/L,0.06 ng/L,0.16 ng/L respectively,with the positive rate of 7.14%.No statistically significant difference was observed between the two groups(P=0.662).Conclusion:Most of PJI were low toxicity infection with little systemic inflammatory response,so the concentration of serum procalcitonin was normal or slightly higher level,had little clinical significance for diagnosis of PJI.But the cases of this retrospective study are not enough,more cases are needed for further study.
作者
罗伟
曾建春
曾意荣
樊粤光
刘志英
李杰
冯文俊
LUO Wei;ZENG Jian-chun;ZENG Yi-rong;PAN Yue-guang;LIU Zhi-ying;LI Jie;FENG Wen-jun(The Third Department of Orthopaedics,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;不详)
出处
《中国骨伤》
CAS
CSCD
2019年第6期531-534,共4页
China Journal of Orthopaedics and Traumatology
关键词
关节成形术
置换
感染
降钙素
手术后并发症
Arthroplasty,replacement
Infection
Calcitonin
Postoperative complications
