在患有类风湿性关节炎的患者中诊断周围假肢关节感染
Yulai Wang1, Guoqing Li1, Baochao Ji1
1Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Bone & joint research
|September 13, 2023
概括
在类风湿性关节炎 (RA) 患者中诊断周围假肢关节感染 (PJI) 通过使用突液白细胞计数 (WBC) 得到改善. 结合多个检测指数,为早期和准确的RA-PJI诊断提供了一种可靠的方法.
科学领域:
- 整形外科 整形外科 整形外科
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
背景情况:
- 周围假肢关节感染 (PJI) 是关节整形术后的一个重大并发症.
- 在风湿性关节炎 (RA) 患者中准确诊断PJI具有独特的挑战.
- 区分RA-PJI和骨关节炎-PJI (OA-PJI) 对于有效治疗至关重要.
研究的目的:
- 确定RA-PJI中血清和突液标记物的最佳诊断值.
- 评估RA-PJI的各种指数的诊断疗效.
- 为了比较RA-PJI和OA-PJI之间的诊断性能.
主要方法:
- 对348名接受了全膝盖 (TKA) 或关节整形手术 (THA) 的患者 (RA和OA) 的回顾性分析.
- 利用接收器操作特征 (ROC) 曲线分析来确定CRP,ESR,突液WBC和PMN%的最佳切断值.
- 使用曲线下的面积 (AUC) 和综合指数分析评估诊断疗效.
主要成果:
- 对于RA-PJI诊断的最佳切线值:CRP 12.5 mg/l,ESR 39 mm/hr,突液 WBC 3.654 /μl,PMN% 65.9%. 这是一个非常好的标准.
- 突流体WBC表现出优异的特异性 (94.4%),积极的预测值 (97.1%) 和RA-PJI的AUC (0.916).
- 综合指数分析实现了100%的特异性和积极的预测值.
结论:
- 血清和突液指数对于诊断RA-PJI非常有价值.
- 同胞液白细胞计数 (WBC) 是RA-PJI最有效的单一检测指数.
- 结合多个诊断索引可以提高RA-PJI早期和准确的检测.
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