骨感染患者血清CRP、PCT、IL-6水平与病情发展和预后的关系

The Relationships Between Serum CRP,PCT and IL-6 Levels and the Progression and Prognosis of Bone Infection

目的探讨骨感染患者血清C反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)水平与病情发展和预后的关系。方法病例源于2018年1月至2019年1月本院骨科收治的88例骨感染患者(作为疾病组)和32无骨感染患者(作为对照组),依据疾病组患者的感染程度分为轻度组(n=30)、中度组(n=35)、重度组(n=23),检测各组血清CRP、PCT、IL-6水平,分析血清CRP、PCT、IL-6水平与骨感染患者病情发展、预后的关系。结果不同病情程度骨感染患者血清CRP、PCT、IL-6水平存在明显的差异,且均较对照组明显升高,表现为重度组>中度组>轻度组>对照组(P<0.05);Logistic回归分析提示CRP、PCT、IL-6水平是骨感染严重程度的影响因素(P<0.05);术后半年随访复发率23.86%,复发者血清CRP、PCT、IL-6水平均明显高于未复发者(P<0.05);且Spearman相关性分析显示骨感染患者复发与术前CRP、PCT、IL-6水平均呈明显的正相关(r=0.791、0.928、0.942,均P<0.001)。结论骨感染患者血清CRP、PCT、IL-6水平与其病情严重、预后复发存在明显的正相关,或可通过监测CRP、PCT、IL-6水平以预测患者病情发展和预后。

Objective To investigate the relationships between serum C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)levels and the progression and prognosis of bone infection.Methods 88 patients with bone infection(the disease group)and 32 patients without bone infection(the control group)who were admitted to orthopedics department of the hospital between January,2018 and January,2019 were enrolled in the study.They were divided into the mild group(n=30),moderate group(n=35)and severe group(n=23)according to the degrees of infection.Serum CRP,PCT and IL-6 levels were detected,and the relationships between their levels and the progression and prognosis of the infected patient were analyzed.Results There were significant differences in serum CRP,PCT and IL-6 levels among patients with different severities of bone infection,and the order of levels from high to low was as follows:the severe group,moderate group,mild group,and the control group(P<0.05).Logistic regression analysis showed that CRP,PCT and IL-6 levels were factors influencing the severity of bone infection(P<0.05).The recurrence rate in half-year follow-up was 23.86%.Serum CRP,PCT and IL-6 levels were significantly higher in patients with recurrence than those without(P<0.05).Spearman correlation analysis showed that the recurrence of bone infection was significantly positively correlated with preoperative CRP,PCT and IL-6 levels(r=0.791,0.928,0.942,all P<0.001).Conclusion Serum CRP,PCT and IL-6 levels in patients with bone infection are significantly positively correlated with the severity and prognosis.The levels of CRP,PCT and IL-6 can be monitored to predict the progression and prognosis of the disease.