比较血沉、C反应蛋白、术中冰冻切片单独及联合诊断髋关节假体感染的效率

Role of erythrocyte sedimentation rate, C reactive protein, intraoperative frozen section alone and their combination in diagnosis of hip periprosthetic infection: A comparative study

目的评价血沉、C反应蛋白、术中冰冻切片单独及联合诊断全髋关节假体周围感染的价值。方法对我科2010年收治的116例行人工全髋关节翻修术的患者进行回顾性分析,以血沉、C反应蛋白及术中冰冻切片作为诊断标准对人工全髋关节感染进行诊断,其中任意两项阳性即诊断为假体感染,任意两项阴性即诊断为无菌性松动,并与"金标准"的诊断结果进行比较。结果血沉、C反应蛋白、术中冰冻切片单独及3项检查方法联合诊断人工髋关节假体周围感染的敏感性分别为76.39%、81.94%、87.5%、97.22%;特异性分别为82.69%、92.31%、94.23%、98.07%;准确性分别为79.03%、86.29%、90.32%、97.58%。结论联合血沉、C反应蛋白及术中冰冻切片可显著提高对髋关节假体周围感染的诊断。

Objective To assess the role of erythrocyte sedimentation rate （ESR）, C reactive protein （CRP）, intraoperative frozen section alone and their combination in diagnosis of hip periprosthetic infection. Methods Clinical data about 116 patients who underwent hip revision surgery in our hospital in 2010 were retrospectively analyzed. Their hip periprosthetie infection was diagnosed with ESR, CRP, intra-operative frozen section alone and their combination. It was diagnosed as prosthetic infection when any two of them were positive and as aseptic loosening when any two of them were negative, and compared with the diagnosis according to the ＂gold standard＂. Results The diagnosis rate of ESR, CRP, intra-operative frozen section and their combination was 76.39%, 81.94%, 87.5% and 97.22%, respectively, for hip periprosthetic infection, with a specificity of 82.69%, 92.31%, 94.23%, 98.07%, respectively, and an accuracy of 79.03%, 86.29%, 90.32%, 97.58%, respectively. Conclusion Combined ESR, CRP and intra-operative frozen section can significantly improve the diagnosis of hip peri-prosthetic infection.