血清C反应蛋白与白蛋白比值、尿基质金属蛋白-7及微量白蛋白对髋关节置换术后假体感染的预测价值

The Predictive Value of Serum C-reactive Protein to Albumin Ratio,Urinary Matrix Metalloproteinase-7,and Microalbumin for Prosthetic Infection After Hip Replacement Surgery

目的:分析血清C反应蛋白与白蛋白比值(CRP/ALB)、尿基质金属蛋白-7(MMP-7)及微量白蛋白(MA)对髋关节置换术后假体感染的预测价值。方法:纳入髋关节置换手术患者共187例为研究对象,随访患者90 d的感染情况,其中28例术后假体感染患者设为感染组,159例未感染患者设为对照组。对2组患者资料进行单因素分析,对有统计学意义的因素行Logistic多因素分析,分析髋关节置换术后假体感染的危险因素,并分析CRP/ALB、MMP-7、MA对髋关节置换术后假体感染的预测价值。结果:感染组患者BMI水平、患部手术史发生率、手术时间、术后第1天引流量、术后总引流量、住院时间、激素使用史发生率、低蛋白血症、贫血、白细胞尿、C反应蛋白(CRP)水平、CRP/ALB水平、MMP-7水平、MA水平、免疫抑制剂使用史发生率均高于对照组,差异有统计学意义(P<0.05);Logistic分析结果显示,CRP/ALB≥2.5、MMP-7≥22μg·g^(-1)、MA≥15 mg·L^(-1)均为髋关节置换术后假体感染的危险因素(P<0.05);CRP/ALB、MMP-7、MA对髋关节置换术后假体感染均有一定的预测价值,但三项联合的预测价值高于其他单项预测。结论:CRP/ALB≥2.5、MMP-7≥22μg·g^(-1)、MA≥15 mg·L^(-1)均为髋关节置换术后假体感染的危险因素,且三者联合应用对髋关节置换术后假体感染有较佳的预测价值。

Objective:To analyze the predictive value of serum C-reactive protein to albumin ratio(CRP/ALB),urinary matrix met-alloproteinase-7(MMP-7),and microalbumin(MA)for prosthetic infection after hip replacement surgery.Methods:A total of 187 pa-tients who underwent hip replacement surgery were included as the study subjects,and the infection status of the patients was followed up for 90 days.Among them,28 patients with postoperative prosthetic infection were set as the infection group,and 159 patients without in-fection were set as the control group.We performed univariate analysis on the data of two groups of patients,performed logistic multivari-ate analysis on statistically significant factors,analyzed the risk factors for prosthetic infection after hip replacement surgery,and analyzed the predictive value of CRP/ALB,MMP-7,and MA for prosthetic infection after hip replacement surgery.Results:The BMI level,inci-dence of surgical history in the affected area,surgical time,postoperative drainage volume on the first day,total postoperative drainage volume,length of hospital stay,incidence of hormone use history,hypoalbuminemia,anemia,white blood cell urine,C-reactive protein(CRP)level,CRP/ALB level,MMP-7 level,MA level,and history of immunosuppressive therapy in the infection group were all higher than those in the control group,and the difference was statistically significant(P<0.05).The results of logistic analysis results showed that CRP/ALB≥2.5 and MMP-7≥22μg·g^(-1) and MA≥15 mg·L^(-1) were both risk factors for prosthetic infection after hip replacement sur-gery(P<0.05).CRP/ALB,MMP-7,and MA all had certain predictive value for prosthetic infections after hip replacement surgery,but the predictive value of CRP/ALB+MMP-7+MA was higher than other single item predictions.Conclusion:CRP/ALB≥2.5,MMP-7≥22μg·g-1 and MA≥15 mg·L^(-1) are both risk factors for prosthetic infection after hip replacement surgery,and their combined use has better predictive value for prosthetic infection after hip replacement surgery.