中国组织工程研究Issue(44)：7097-7102,6.DOI:10.3969/j.issn.2095-4344.2015.44.009
不同生物标记物预测关节置换后假体周围感染与无菌性松动的效能分析
Different biomarkers predict periprosthetic joint infection and aseptic loosening after joint arthroplasty
摘要
Abstract
BACKGROUND:Periprosthetic joint infection is a complication that is difficult to deal with after joint arthroplasty. Early diagnosis is the key to treatment. To find a fast response, high-sensitivity and high-specificity molecular biomarker can significantly optimize the diagnosis process of periprosthetic joint infection. OBJECTIVE:To monitor blood procalcitonin, interleukin-6 and lipopolysaccharide binding protein levels, to compare with blood leukocyte count and C-reactive protein levels, to identify above indexes, and to distinguish sensitivity and specificity of periprosthetic joint infection. METHODS: A total of 81 patients with pain after arthroplasty who were treated in Affiliated Hospital of Jining Medical Colege from January 2008 to December 2013 were enroled in this study. The repair surgery of al patients was divided into two stages. In the first stage, complete debridement and the instalation of temporary occupancy device were conducted. After 3 months averagely, two-phase reconstruction was performed. At 1 day before surgery, venous blood was colected. Calcitonin, interleukin 6, lipopolysaccharide binding protein, leukocyte count and C- reactive protein levels were detected. During the operation, synovial membrane and sample of false envelope around the prosthesis were colected. Bacterial and histological examinations were performed. The sensitivity and specificity were calculated using receiver operating characteristic curve. <br> RESULTS AND CONCLUSION: One-way analysis of variance results showed that the receiver operating characteristic curve of lipopolysaccharide binding protein was bigger, 0.962; 95 confidence interval 0.924-1.000. Diagnostic value was optimal, and the critical value was 23.5 μg/L. These data suggested that when lipopolysaccharide binding protein exceeded 23.5 μg/L before surgery, periprosthetic joint infection would be identified. The receiver operating characteristic curve of C-reactive protein was 0.871. The receiver operating characteristic curve of leukocytes was close to 0.5. The diagnostic value of leukocyte count on periprosthetic joint infection was not great. These findings indicate that lipopolysaccharide binding protein has good application prospect in the diagnosis of periprosthetic joint infection after joint replacement, and shows high positive predictive rate and negative predictive rate of periprosthetic joint infection.关键词
骨科植入物/人工假体/感染/关节置换/脂多糖结合蛋白/假体周围感染/无菌性松动/山东省自然科学基金分类
医药卫生引用本文复制引用
张玉革,王国栋,张元民,赵晓伟,牛帅帅..不同生物标记物预测关节置换后假体周围感染与无菌性松动的效能分析[J].中国组织工程研究,2015,(44):7097-7102,6.基金项目
山东省自然科学基金项目(ZR2010HQ036) （ZR2010HQ036）
