血清HBd-3、TNFα表达水平在全膝关节置换术后早期假体周围感染诊断中的意义

Significance of expression levels of serum HBd-3 and TNFαin early diagnosis of periprosthetic infection after total knee arthroplasty

目的研究血清β-防御素-3(HBd-3)、肿瘤坏死因子α(TNFα)表达水平在全膝关节置换术后早期假体周围感染诊断中的意义。方法感染组纳入自2011-02—2018-11全膝关节置换术后早期假体周围感染92例,选取同期全膝关节置换术后未感染92例作为对照组。比较组内术前、术后1 d、术后3 d、术后7 d血清HBd-3蛋白与TNFα水平,比较组间术后1 d、术后3 d、术后7 d血清HBd-3蛋白与TNFα水平,比较组间术后3 d血清CRP、ESR、WBC。结果感染组与对照组术后1 d血清HBd-3蛋白、TNFα水平较术前明显升高,感染组术后3 d、术后7 d持续升高,而对照组术后3 d恢复到术前水平。感染组术后1 d血清HBd-3水平低于对照组,但术后3 d、术后7 d血清HBd-3水平明显高于对照组;感染组术后1 d、术后3 d、术后7 d血清TNFα水平明显高于对照组;感染组术后3 d血清CRP、ESR、WBC水平明显高于对照组,差异有统计学意义(P<0.05)。全膝关节置换术后早期假体周围感染患者术后3 d血清HBd-3蛋白、TNFα水平与CRP、ESR、WBC呈正相关(P<0.05)。结论血清HBd-3、TNFα在全膝关节置换术后早期假体周围感染患者中表达水平较高,且与CRP、ESR、WBC水平呈正相关,可能对早期假体周围感染有一定的预测和诊断价值。

Objective To study the significance of expression levels of serumβ-defensin-3(HBd-3)and tumor necrosis factorα(TNFα)in the early diagnosis of periprosthetic infection after total knee arthroplasty.Methods From February 2011 to November 2018,a total of 92 cases of early periprosthetic infection after total knee arthroplasty were included in the infection group,at the same time,92 uninfected patients after total knee arthroplasty were selected as the control group.The levels of serum HBd-3 protein and TNFαbefore operation,on 1st,3rd and 7th day after operation were compared within groups,the levels of serum HBd-3 protein and TNFαon 1st,3rd and 7th day after operation were compared between the two groups,and the serum CRP,ESR and WBC were compared between the two groups on 3rd day after operation.Results The levels of serum HBd-3 protein and TNFαin the infection group and the control group on the 1st day after operation were significantly higher than those before operation,the levels of serum HBd-3 protein and TNFαin the infection group increased continuously on the 3rd and 7th day after operation,and the levels of serum HBd-3 protein and TNFαin the control group recovered to the preoperative levels on 3rd day after operation.The level of serum HBd-3 in the infection group was lower than that in the control group on 1st day after operation,however,the level of serum HBd-3 was significantly higher than that in the control group on 3rd day and 7th day after operation;the level of serum TNFαin the infection group was significantly higher than that in the control group on the 1st,3rd and 7th day after operation;and the levels of CRP,ESR and WBC in the infected group were significantly higher than those in the control group on the 3rd day after operation(P<0.05).The levels of serum HBd-3 protein and TNFαof patients with early periprosthetic infection after total knee arthroplasty on the 3rd day after total knee replacement were positively correlated with CRP,ESR and WBC(P<0.05).Conclusion The expression levels of serum HBd-3 and TNFαin patients with early periprosthetic infection after total knee arthroplasty are high,which are positively correlated with the levels of CRP,ESR and WBC,and may have certain predictive and diagnostic value for early periprosthetic infection.