在查膝关节关节假肢感染时常见的炎症标志物
Jacopo Conteduca1, Marco Filipponi1, Paolo Pichierri1
1Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy.
概括
血清C反应蛋白 (CRP) 在诊断早期和晚期全膝关节整形术 (TKA) 感染方面表现出中度的准确性. 对于持续的炎症,建议进行突流体分析,以准确诊断周围假肢关节感染 (PJI).
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 生物标志物 生物标志物
背景情况:
- 周围假肢关节感染 (PJI) 是全膝关节整形术 (TKA) 后的一种严重并发症.
- 早期和准确的TKA感染诊断对于成功的治疗结果至关重要.
- 血清C反应蛋白 (CRP) 是一种常用的炎症标记物,但其在TKA感染中的实用性需要进一步评估.
研究的目的:
- 评估血清C反应蛋白 (CRP) 诊断准确性,用于膝关节全关节整形术 (TKA) 后的早期和晚期感染.
- 确定CRP的敏感性和特异性,以区分感染者与未感染的TKA患者.
主要方法:
- 在不同时间点对TKA患者血清CRP水平的前性评估:手术前,手术后 (1日,7日,15日) 和长期随访 (1-36个月).
- 感染被使用维德默分类来分类.
- 统计分析,包括千平方或费舍尔精确测试,用于比较分类变量 (p < 0.05).
主要成果:
- 总共有19个感染被诊断出来,5个是早期的,14个是晚期的慢性病例.
- 在TKA后的第一个月,血清CRP在识别感染时表现出80%的灵敏度和67.6%的特异性,并指出了一些错误的阳性结果.
- 早期的感染呈现出典型的症状,如发烧,胀和疼痛.
结论:
- 血清CRP在准确诊断TKA感染方面存在局限性,特别是具有显著的错误阳性率.
- 对于持久性炎症症状的患者,即使没有放松的放射性迹象,也建议吸收突液,以确定诊断.
- 建议进行血清和突液测试的组合,以最佳地诊断周围假肢关节感染 (PJI).
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