周围假肢关节感染:现代诊断标记及其局限性
Adeolu Badejo1, Michael O Kolade2, Abiodun C Adegbesan3
1Orthopaedic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, GBR.
Cureus
|January 30, 2026
概括
在关节关节整形术后诊断周围假肢关节感染 (PJIs) 仍然具有挑战性. 结合临床评估与先进生物标志物和分子分析的多模式方法为准确的PJI诊断提供了最有前途的策略.
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
- 医学诊断 医学诊断 医学诊断
背景情况:
- 关节关节整形 (JA) 显著改善生活质量,但存在围围假肢关节感染 (PJI) 的风险.
- PJI导致大量的发病率,高成本和增加的死亡率.
- 由于症状重叠和缺乏明确的标志物,准确和早期的PJI诊断具有挑战性.
研究的目的:
- 审查和评估当前对周围假肢关节感染 (PJI) 的诊断标志物.
- 评估传统,突液和分子标记物的诊断性能.
- 为了探索PJI诊断的未来进展.
主要方法:
- 系统评论,元分析和诊断准确性研究的综合文献搜索.
- 对血清炎症标志物 (CRP,ESR) 的评估.
- 对突液生物标记物的评估 (白细胞化酶,α-防御素,calprotectin) 和分子诊断 (PCR,NGS).
主要成果:
- 传统的血清标记物对慢性/低度感染的敏感性较低.
- 突液生物标志物显示出更好的诊断性能,但面临成本和标准化的局限性.
- 分子诊断为检测困难生物体提供了潜力,但由于成本和复杂性而受到限制.
结论:
- 建议采用多模式诊断方法,将临床评估与各种生物标志物相结合.
- 诊断门的标准化和改善医疗保健工具的可访问性至关重要.
- 人工智能增强模型有望提高诊断信心和患者的治疗结果.
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