急性时相蛋白、降钙素原及免疫指标在膝关节置换术后早期感染患者中的检测意义
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摘要
目的探讨急性时相蛋白、降钙素原及免疫指标在膝关节置换术后早期感染患者中的检测意义,为该类手术患者早期感染的诊断提供依据。方法将2014年12月-2016年5月医院收治的36例膝关节置换术后早期感染设为A组,同时期的36例未发生感染的膝关节置换术患者为B组,36名健康人员为C组,比较3组受试人员的血清急性时相蛋白、降钙素原及免疫指标,并比较A组浅层感染和深部感染患者的上述检测指标。结果 A组的血清急性时相蛋白指标CRP、α1-AT、CER及α1-AG水平分别为(6.12±0.59)mg/L、(3.12±0.22)g/L、(564.24±32.78)mg/L及(118.98±12.45)mg/dl,其分别高于B组的(4.78±0.49)mg/L、(1.63±0.15)g/L、(419.78±28.75)mg/L、(92.34±9.73)mg/dl及C组的(2.21±0.25)mg/L、(0.59±0.05)g/L、(271.63±25.38)mg/L、(59.69±5.34)mg/dl,B组则高于C组;A组的血清降钙素原高于B组及C组,B组则高于C组;免疫指标A组差于B组及C组B组则差于C组,且A组深部感染患者则差于浅层感染患者,差异均有统计学意义(P<0.05)。结论急性时相蛋白、降钙素原及免疫指标在膝关节置换术后早期感染患者中的检测意义较高,对于感染的早期检测及感染情况的了解均有较高的价值。
OBJECTIVE To explore the significance of detection of acute phase protein,procalcitonin,and immune indexes in patients with early infection after knee replacement so as to provide guidance for diagnosis of such group of patients with early infection.METHODS From Dec 2014 to May 2016,totally 36 patients who had the early infection after the knee replacement were assigned as the group A,meanwhile,36 patients who did not have the early infection after the knee replacement were set as the group B,and 36 healthy people were chosen as the group C.The serum acute phase protein,procalcitonin,and immune indexes were compared among the three groups of participants;the above indexes were observed and compared between the patients with superficial infection and the patients with deep infection in the group A.RESULTS The levels of serum acute phase protein CRP,α1-AT,CER,andα1-AG of the group A were respectively(6.12±0.59)mg/L,(3.12±0.22)g/L,(564.24±32.78)mg/L,and(118.98±12.45)mg/dl,higher than(4.78±0.49)mg/L,(1.63±0.15)g/L,(419.78±28.75)mg/L,and(92.34±9.73)mg/dl of the group B and(2.21±0.25)mg/L,(0.59±0.05)g/L,(271.63±25.38)mg/L,and(59.69±5.34)mg/dl of the group C;the levels of the above indexes of the group B were higher than those of the group C.The level of serum procalcitonin of the group A was higher than that of the group B and the group C,and it was higher in the group B than in the group C.The immune indexes of the group A were worse than those of the group B and the group C,and they were worse in the group B than in the group C;in the group A,the immune indexes of the patients with deep infection were worse than those of the patients with superficial infection,and there was significant difference(P<0.05).CONCLUSIONThe detection of acute phase protein,procalcitonin,and immune indexes has great significance to the patients with early infection after the knee replacement and has high value in detection of infection in early stage as well as understanding of prevalence of infection.
OBJECTIVE To explore the significance of detection of acute phase protein,procalcitonin,and immune indexes in patients with early infection after knee replacement so as to provide guidance for diagnosis of such group of patients with early infection.METHODS From Dec 2014 to May 2016,totally 36 patients who had the early infection after the knee replacement were assigned as the group A,meanwhile,36 patients who did not have the early infection after the knee replacement were set as the group B,and 36 healthy people were chosen as the group C.The serum acute phase protein,procalcitonin,and immune indexes were compared among the three groups of participants;the above indexes were observed and compared between the patients with superficial infection and the patients with deep infection in the group A.RESULTS The levels of serum acute phase protein CRP,α1-AT,CER,andα1-AG of the group A were respectively(6.12±0.59)mg/L,(3.12±0.22)g/L,(564.24±32.78)mg/L,and(118.98±12.45)mg/dl,higher than(4.78±0.49)mg/L,(1.63±0.15)g/L,(419.78±28.75)mg/L,and(92.34±9.73)mg/dl of the group B and(2.21±0.25)mg/L,(0.59±0.05)g/L,(271.63±25.38)mg/L,and(59.69±5.34)mg/dl of the group C;the levels of the above indexes of the group B were higher than those of the group C.The level of serum procalcitonin of the group A was higher than that of the group B and the group C,and it was higher in the group B than in the group C.The immune indexes of the group A were worse than those of the group B and the group C,and they were worse in the group B than in the group C;in the group A,the immune indexes of the patients with deep infection were worse than those of the patients with superficial infection,and there was significant difference(P<0.05).CONCLUSIONThe detection of acute phase protein,procalcitonin,and immune indexes has great significance to the patients with early infection after the knee replacement and has high value in detection of infection in early stage as well as understanding of prevalence of infection.
引文
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[8]高玉镭,张寅权,宋方龙,等.切除与不切除滑膜对人工全膝关节置换术后感染影响的比较[J].中国矫形外科杂志,2016,24(5):411-415.
[9]Alfargieny R,Bodalal Z,Bendardaf R,et al.Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty[J].Avicenna J Med,2015,5(4):117-122.
[10]Gjika E,Uckay I,Suva D.Management of an infection associated with a prosthetic arthroplasty:the necessity of collaboration between surgeon and infectiologist[J].Rev Med Suisse,2015,11(484):1618-1622.
[2]Tayton ER,Frampton C,Hooper GJ,et al.The impact of patient and surgical factors on the rate of infection after primary total knee arthroplasty:an analysis of 64 566joints from the New Zealand Joint Registry[J].Bone Joint J,2016,98(3):334-340.
[3]胡雨.骨科围手术期C反应蛋白动态监测的临床意义[J].海南医学院学报,2014,20(4):513-515.
[4]Torres-Claramunt R,Gil-Gonzalez S,Leal J,et al.A new score assessing the surgical wound of a TKA and its relation with pain,infection and functional outcome[J].Acta Orthop Belg,2015,81(4):713-719.
[5]Kim YH,Kulkarni SS,Park JW,et al.Comparison of infection control rates and clinical outcomes in culture-positive and culture-negative infected total-knee arthroplasty[J].J Orthop,2015,12(Suppl 1):37-43.
[6]Singh H,Thomas S,Agarwal S,et al.Total knee arthroplasty in women with asymptomatic urinary tract infection[J].J Orthop Surg(Hong Kong),2015,23(3):298-300.
[7]Lee QJ,Mak WP,Wong YC.Risk factors for periprosthetic joint infection in total knee arthroplasty[J].J Orthop Surg(Hong Kong),2015,23(3):282-286.
[8]高玉镭,张寅权,宋方龙,等.切除与不切除滑膜对人工全膝关节置换术后感染影响的比较[J].中国矫形外科杂志,2016,24(5):411-415.
[9]Alfargieny R,Bodalal Z,Bendardaf R,et al.Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty[J].Avicenna J Med,2015,5(4):117-122.
[10]Gjika E,Uckay I,Suva D.Management of an infection associated with a prosthetic arthroplasty:the necessity of collaboration between surgeon and infectiologist[J].Rev Med Suisse,2015,11(484):1618-1622.