假体周围感染诊断新进展

Advances in diagnosis of periprosthetic joint infection

假体周围感染(PJI)是关节置换术后一种严重的并发症,虽然该病的诊断方法多种,但目前尚无"金标准",同时由于目前使用的部分诊断手段灵敏度与特异度较低,导致结果的解读较模糊。近年来发现的一些较新的诊断技术,如白细胞酯酶检测,α-防御素为代表的关节液生物标记物,具有极高的敏感性与特异性,但目前尚未在国内推广。还有很多学者与临床医生在研究超声裂解及多聚酶链反应(PCR)技术来提高细菌培养阳性率,但这些方法操作复杂,可行性低,因此需进一步研究更加简便、准确、稳定且应用性强的检查手段。

Periprosthetic joint infection(PJI)is a devastating complication after total joint arthroplasty.Although there are many diagnostic methods for this disease,there is no“golden standard”for the diagnosis of PJI.Because of the low sensitivity and specificity of some diagnostic tools,as a result,the interpretation of the results are obscure.In recent years,a number of new diagnostic techniques,such as leukocyte esterase assays andα-defensins have been identified as representative factors of the joint fluid biomarkers,with high sensitivity and specificity,but it has not been popularized in China yet.With the development of technology,there are many scholars and clinicians studying ultrasound lysis and polymerase chain reaction technology to improve the positive rate of culture.But these methods are complicated and low feasibility,more researches are needed for more simple,accurate,stable and practical methods.