白细胞介素-6和C反应蛋白水平在人工关节置换术前后的临床意义

Clinical Significance of Interleukin- 6 and C Reactive Protein Levels before and after Artificial Joint Replacement

目的探讨血清白介素6(IL-6)和C-反应蛋白(CRP)对关节置换术后早期感染的诊断价值.方法选择行人工髋、膝关节置换术患者共66例,分别检测术前、术后1、3、5、7、14 d的血清IL-6及CRP水平.结果患者术前血清IL-6水平为(38.5±8.2)pg/m L,术后1 d急剧升高,之后迅速下降,术后3 d恢复至正常值,与术前比较,术后1 d血清IL-6水平显著升高,差异有统计学意义(P<0.05).患者术前血清CRP水平为(5.3±2.2)mg/L,术后逐渐升高,术后第3天达到最高峰(126.7±43.6)mg/L,之后逐渐回落,与术前比较,术后各时间点均显著升高,差异有统计学意义(P<0.05).按照是否发生术后感染分为未感染组(60例)和感染组(6例),术前2组血清IL-6、CRP水平差异无统计学意义(P>0.05);术后1 d、3 d,感染组血清IL-6、CRP水平的均明显高于未感染组,差异有统计学意义(P<0.05).结论 IL-6和CRP与人工关节置换术后的炎症反应密切相关,动态监测血清IL-6和CRP水平对早期诊断术后感染具有重要价值.

Objective To investigate the early diagnosis value of the serum interleukin 6（IL- 6） and C- reactive protein（CRP） levels after joint replacement.Methods 66 patients who were cured by totle hip and knee arthroplasty were analyzed,the serum IL- 6 and CRP levels were measured before surgery,1,3,5,7,14 days.Results Serum IL- 6 level was（38.5 ±8.2） pg/m L preoperatively, that increased rapidly at day 1postoperatively,and thereafter a rapid return to normal concentrations an day 3.Compared with the preoperative,postoperative serum IL- 6 levels at day 1 were significantly increased, the difference was statistically significant（P〈0.05）.Preoperative serum CRP level was（5.3±2.2） mg/L,that rose more slowly and reached maximum levels（126.7 ±43.6） mg/L at day 3 postoperatively, then descended slowly.Compared with the preoperative,postoperative serum CRP level was significantly increased at each time point, the difference was statistically significant（P 0.05）.According to infection patients were divided into non infection group（60 cases） and infection group（6 cases）,preoperative serum IL- 6,CRP levels of the two groups were not significantly different（P〈0.05）;at 1d,3 d postoperatively,serum IL- 6,CRP levels in infection group were significantly higher than those in non infected group（P〈0.05）.Conclusion IL- 6 and CRP are closely related to inflammatory reaction after artificial joint replacement, and dynamic monitoring of serum IL- 6 and CRP levels has important value in early diagnosis of postoperative infection.