[1]李向平,胡　淼,李勇军.血清D-二聚体和炎症指标单独及联合检测对髋、膝关节置换术后假体周围感染的诊断价值[J].新乡医学院学报,2021,38(4):337-340.[doi:10.7683/xxyxyxb.2021.04.008]
　LI Xiangping,HU Miao,LI Yongjun.Diagnostic value of serum D-dimer and inflammatory indexes alone and combined detection for periprosthetic joint infection after hip and knee joint replacement[J].Journal of Xinxiang Medical University,2021,38(4):337-340.[doi:10.7683/xxyxyxb.2021.04.008]
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血清D-二聚体和炎症指标单独及联合检测对髋、膝关节置换术后假体周围感染的诊断价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年4
页码:
337-340
栏目:
临床研究
出版日期:
2021-04-05

文章信息/Info

Title:
Diagnostic value of serum D-dimer and inflammatory indexes alone and combined detection for periprosthetic joint infection after hip and knee joint replacement
作者:
李向平1; 胡　淼2; 李勇军1
［1.河南省洛阳正骨医院（河南省骨科医院）检验科，河南　郑州　450000；2.新乡医学院三全学院医学检验学院，河南　新乡　453003］
Author(s):
LI Xiangping1; HU Miao2; LI Yongjun1
［1.Department of Laboratory Medicine，Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hosptial),Zhengzhou 450000,Henan Province,China2.School of Laboratory,Sanquan College of Xinxiang Medical University,Xingxiang 453003,Henan Province,China］
关键词:
假体周围感染; D-二聚体; 红细胞沉降率; C-反应蛋白; 降钙素原; 白细胞
Keywords:
periprosthetic joint infection D-dimer erythrocyte sedimentation rate C-reactive protein procalcitonin leukocyte
分类号:
R318，R68
DOI:
10.7683/xxyxyxb.2021.04.008
文献标志码:
A
摘要:
目的　探讨血清D-二聚体和炎症指标单独及联合检测对髋、膝关节置换术后假体周围感染（PJI）的诊断价值。方法　选择2018年1月至2020年6月河南省洛阳正骨医院行髋、膝关节置换术的124例患者为研究对象。根据初次人工膝、髋关节置换术后是否发生PJI或无菌性松动将患者分为无症状组（n=45）、无菌松动组（n=42）和PJI组（n=37）。比较3组患者术前1 d外周静脉血中D-二聚体、红细胞沉降率(ESR)、C-反应蛋白(CRP)、降钙素原(PCT) 和白细胞 (WBC)水平。采用受试者工作特征曲线评估D-二聚体、ESR、CRP单独及联合检测对髋、膝关节置换术后PJI的诊断价值。结果　无症状组与无菌松动组患者外周静脉血中D-二聚体、ESR和CRP水平比较差异无统计学意义（P＞0.05）。PJI组患者外周静脉血中D-二聚体、ESR和CRP水平均显著高于无症状组和无菌松动组（P＜0.05）。3组患者外周静脉血中PCT、WBC水平比较差异无统计学意义（P＞0.05）。以D-二聚体>1.08 mg·L-1、ESR>21 mm·h-1、CRP>8.7 mg·L-1作为阳性判定标准，D-二聚体+ESR、D-二聚体+CRP、CRP+ESR和D-二聚体+ESR+CRP联合诊断髋、膝关节置换术后PJI的特异度显著高于D-二聚体、ESR、CRP（P<0.05)；d-二聚体+esr+crp联合诊断髋、膝关节置换术后pji的特异度显著高于d-二聚体+esr（>P<0.05)。>结论　血清D-二聚体、CRP和ESR联合检测对髋、膝关节置换术后PJI的诊断价值较高。undefinedundefined
Abstract:
Objective　To investigate the diagnostic value of D-dimer and inflammatory indicators alone and combined detection for periprosthetic joint infection (PJI) after hip and knee joint replacement.Methods　　A total of 124 patients who underwent hip and knee joint replacement in Luoyang Orthopedic-Traumatological Hospital of Henan Province from January 2018 to June 2020 were selected as research objects.All patients were divided into asymptomatic group (n=45),aseptic loosening group (n=42) and PJI group (n=37) according to whether PJI or aseptic loosening occurred after the initial artificial knee and hip joint replacement.The D-dimer,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),Procalcitonin (PCT) and white blood cell (WBC) levels in peripheral venous blood of patients were compared among the three groups one day before surgery.The diagnostic value of D-dimer,ESR,CRP alone and combined detection for PJI after knee and hip arthroplasty were evaluated by the receiver operating characteristic curve.Results　There was no significant difference in the levels of D-dimer,ESR and CRP in peripheral venous blood of patients between the asymptomatic group and the aseptic loosening group (P>0.05).The levels of D-dimer,ESR,and CRP in peripheral venous blood of patients in PJI group were significantly higher than those in asymptomatic group and aseptic loosening group (P<0.05).There was no significant difference in the levels of PCT and WBC in peripheral venous blood of patients among the three groups (P>0.05).D-dimer>1.08 mg·L-1,ESR>21 mm·h-1,CRP>8.7 mg·L-1 was used as the positive criterion，the specificity of the combined detected of D-dimer+ESR,D-dimer+CRP,CRP+ESR and D-dimer+ESR+CRP were significantly higher than those of the separate detection of D-dimer,ESR,CRP in the diagnosis of PJI after hip and knee arthroplasty (P<0.05); the specificity of the combined detected of D-dimer+ESR+CRP was significantly higher than that of D-dimer+ESR (P<0.05).Conclusion　The combined detection of D-dimer,CRP and ESR is of higher value in the diagnosis of PJI after hip and knee joint replacement.

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更新日期/Last Update: 2021-04-05