血清白细胞介素6和降钙素水平预测人工全膝关节置换术后早期假体周围感染的相关研究

A study on the prediction of early periprosthetic infection after artificial total knee arthroplasty by serum interleukin-6 and calcitonin levels

目的探究血清白细胞介素6(IL-6)和降钙素(PCT)对人工全膝关节置换术(TKA)后早期假体周围感染(PJI)的预测作用。方法本研究为回顾性病例对照研究,收集自2017年1月至2023年1月青岛大学附属医院关节外科收治的147例骨关节炎(OA)患者为研究对象,根据TKA术后是否合并PJI进行分组,分成对照组和感染组,其中对照组患者84例,感染组患者63例。记录两组患者的一般资料,手术相关资料和血清指标,单因素分析和多因素分析均采用Logistic回归模型进行评估。结果感染组体重指数(BMI),既往糖尿病病史,手术时间,血清中IL-6和PCT含量明显高于对照组,差异有统计学意义(P<0.05),单因素和多因素分析结果显示,BMI偏高,既往糖尿病病史,手术时间过长,血清中IL-6和PCT含量升高是TKA置换术后假体周围感染(PJI)的高危因素(P<0.05),当IL-6=14.69 pg/mL时,约登指数处于最高值;当PCT=22.39 ng/mL时,约登指数处于最高值,可以作为截断值。结论BMI偏高,既往糖尿病病史,手术时间过长,血清中IL-6和PCT含量升高是TKA置换术后PJI的高危因素。

Objective To explore the predictive role of serum interleukin-6(IL-6)and procalcitonin(PCT)in the early diagnosis of periprosthetic joint infection(PJI)after total knee arthroplasty(TKA).Methods This was a retrospective case-control study.A total of 147 patients with osteoarthritis(OA)treated at the Department of Orthopedics,Affiliated Hospital of Qingdao University from January 2017 to January 2023 were included.The patients were divided into control group and infection group based on whether PJI occurred after TKA,with 84 patients in the control group and 63 patients in the infection group.General information,perioperative data,and serum biomarkers were collected for both groups.Logistic regression analysis was used for both univariate and multivariate analyses.Results The infection group had significantly higher BMI,history of diabetes mellitus,operation time,IL-6,and PCT levels compared to the control group,and the differences were statistically significant(P<0.05).Univariate and multivariate analyses showed that high BMI,history of diabetes mellitus,prolonged operation time,elevated IL-6,and PCT levels were identified as risk factors for PJI after TKA(P<0.05).When IL-6=14.69 pg/mL,the odds ratio was the highest;when PCT=22.39 ng/mL,the odds ratio was the highest,suggesting these values as cutoff points.Conclusion High BMI,history of diabetes mellitus,prolonged operation time,elevated IL-6,and PCT levels are considered high-risk factors for periprosthetic joint infection(PJI)after TKA.