寻找PJI诊断的黄金标准的持续斗争
Emanuel-Cristian Sandu1,2, Catalin Cirstoiu1,2, Sergiu Iordache1,2
1Department of Orthopedics and Traumatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Reports (MDPI)
|September 22, 2025
概括
诊断周围假肢关节感染 (PJI) 仍然具有挑战性. 目前的多标准协议结合了临床,准临床和分子数据,但需要新的检测技术来提高PJI诊断的生物标志物的准确性.
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
- 生物标志物发现发现
背景情况:
- 周围假肢关节感染 (PJI) 是关节关节整形术的严重并发症.
- 准确诊断PJI是非常重要的,因为与错误诊断相关的患者和医疗保健成本很大.
- 目前没有一个单一的诊断测试能够满足PJI检测的黄金标准要求.
研究的目的:
- 审查PJI目前的诊断技术和技术.
- 评估各种生物标志物 (血清,突,组织) 和分子方法的准确性.
- 确定PJI诊断的局限性和未来方向.
主要方法:
- 对PJI的诊断技术进行系统审查.
- 对血清生物标记物的分析:C反应蛋白,介质素-6,甲酸,D-二次体,ICAM-1.
- 对突生物标记物的评估:抗菌,利波卡林-2,白细胞雌激酶,calprotectin.
- 组织生物标志物的评估:托尔类受体,CD15.
- 分子技术的审查:聚合酶链反应 (PCR),甲基因组下一代测序 (mNGS).
主要成果:
- 综合临床,准临床和分子发现的多标准诊断协议提高了PJI的诊断准确性.
- 各种生物标志物看起来很有前途,但在灵敏度和特异性方面存在局限性.
- 像mNGS这样的先进分子技术为病原体识别提供了潜力,但需要进一步验证.
结论:
- 目前对PJI的诊断方法依赖于联合标准,因为缺乏最终的黄金标准测试.
- 进一步开发新型检测技术对于提高PJI生物标志物的准确性和效率至关重要.
- 未来的研究应该专注于提高生物标志物性能和整合先进的分子诊断,以可靠地检测PJI.
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