IL-6、PCT水平对髋关节置换术后感染的早期预测

The level of IL-6 and PCT in the early prediction of infection after hip replacement

目的探索白细胞介素-6(IL-6)、血清降钙素尿(PCT)的水平对髋关节置换术后发生感染的早期预测价值。方法分析2014年1月至2019年1月安阳市人民医院845例接受人工髋关节置换术的临床资料,发生感染的15例患者为感染组,选取同比例接受手术后未发生感染的30例患者为未感染组,并选择同时间段的健康体检者30例为对照组,分析3组患者的白细胞介素-6(IL-6)、降钙素原(PCT)水平上的差异。结果 IL-6水平上的比较结果:感染组>未感染组>对照组,差异有统计学意义(P<0.05),且两两比较差异均有统计学意义(P<0.05);PCT水平上的比较显示:感染组>未感染组>对照组,差异有统计学意义(P<0.05),且两两比较差异均具有统计学意义(P<0.05)。ROC分析显示:IL-6和PCT在诊断人工髋关节置换术后早期并发感染的AUC分别为0.815、0.772。最佳理论阈值分别为7.0 pg/mL,1.25μg/L。IL-6与PCT联合检测的敏感度、特异度均高于单一检测(P均<0.05)。结论人工髋关节置换术后患者早期易并发感染,炎症因子IL-6、PCT对人工髋关节置换术后早期感染具有一定的诊断价值。

Objective To explore the value of IL-6 and PCT levels in the early prediction of infection after hip replacement.Method The clinical data of 845 patients undergoing artificial hip replacement in Anyang People’s Hospital from January 2014 to January 2019 were analyzed.15 patients with infection were the infection group,and 30 patients who had no infection after the operation were selected as the non-infection group.30 healthy physical examination subjects at the same time period were selected as the control group.The levels of interleukin-6(IL-6),and procalcitonin(PCT) in the three groups were analyzed.Results The results of the comparison of IL-6 levels:The infected group> the uninfected group> the control group,the difference was statistically significant(P<0.05).The comparison of the PCT level showed that:the infected group> the uninfected group> the control group,the difference was statistically significant(P<0.05).ROC analysis showed that the AUC of IL-6 and PCT were 0.815 and 0.772,respectively.The optimal theoretical thresholds were 7.0 pg/mL and 1.25 g/L,respectively.The sensitivity and specificity of the combined detection of IL-6 and PCT were higher than that of the single detection(P<0.05).Conclusion Patients after artificial hip replacement are prone to complicated infections at an early stage.The inflammatory factors IL-6 and PCT have certain diagnostic value for early infections after artificial hip replacement.