血清CRP、ESR水平变化与老年全髋关节置换术后认知功能的相关性研究

Correlation between the Levels of Serum CRP and ESR and the Cognitive Function in Elderly Patients with Total Hip Arthroplasty

目的研究老年全髋关节置换术治疗前后血清C反应蛋白(CRP)、红细胞沉降率(ESR)水平与术后认知功能的相关性。方法抽取2016年2月至2018年1月成都中医药大学附属医院骨科接受全髋关节置换术的60例老年患者,其中术后未发生认知功能障碍(post-operative cognitive dysfunction,POCD)者42例,为对照组;发生POCD者18例,为试验组。所有患者分别于术前、术后接受静脉采血,检测血清CRP、ESR水平,记录CRP、ESR峰值异常率,并采用Logistic回归分析术后POCD与CRP、ESR水平的关系。结果术前、术后6h、1、3、7d试验组血清CRP、ESR水平均明显高于对照组(P<0.05)。与对照组相比,试验组血清CRP、ESR峰值异常率均较高,差异有统计学意义(P<0.05)。Logistic回归分析显示,术前、术后1d血清CRP、ESR水平是POCD的影响因素(P<0.05)。结论血清CRP、ESR水平升高可能增加老年全髋关节置换术后POCD发生风险,术前术后检测血清CRP、ESR水平有助于预测其风险。

Objective To investigate the correlation between the levels of serum C reactive protein （CRP） and erythrocyte sedimentation rate （ESR） and the cognitive function before and after total hip arthroplasty in elderly patients. Methods A total of 60 elderly patients undergoing total hip arthroplasty in Teaching Hospital of Chengdu University of T.C.M from February of 2016 to January of 2018 were selected as the research objects. Among those patients, the 42 patients without postoperative cognitive dysfunction （POCD） were divided into the control group, and the other 18 cases with POCD were divided into the experiment group. The venous blood of all the patients was collected before and after operation to detect the levels of serum CRP and ESR. The abnormal rates of CRP and ESR peak values were recorded. Logistic regression analysis was performed to analyze the correlation between POCD and the levels of CRP and ESR. Results The levels of serum CRP and ESR in the experiment group were significantly higher before operation, 6 hours, 1, 3 and 7 days after operation than those in the control group （ P 〈0.05）. Compared with the control group, the abnormal rates of CRP and ESR peak values were significantly higher in the experiment group （ P 〈0.05）. The results of Logistic regression analysis showed that the levels of serum CRP and ESR before operation and 1 day after operation were the independent influencing factors of POCD （ P 〈0.05）. Conclusion The elevated levels of serum CRP and ESR may increase the risk of POCD after total hip arthroplasty in elderly patients, so it is helpful to predict the risk of POCD by detecting the levels of serum CRP and ESR before and after operation.