血清G-CSF、suPAR、IL-1β水平对老年膝骨关节置换术后假体周围感染的预测价值

Prognostic value of serum G-CSF,suPAR and IL-1β levels in periprosthesis infection after knee osteoarthritis replacement in elderly patients

目的探讨血清粒细胞集落刺激因子(G-CSF)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、白细胞介素-1β(IL-1β)水平对老年膝骨关节置换术后假体周围感染(PJI)的预测价值.方法选取2016年8月—2023年8月浦东新区花木社区卫生服务中心收治的老年膝骨关节置换术后PJI患者80例为研究组,以1∶1配对研究纳入同期老年膝骨关节置换术后无PJI患者80例为对照组;检测两组血清G-CSF、suPAR、IL-1β水平与C-反应蛋白(CRP)、白细胞计数(WBC)、红细胞沉降率(ESR),分析其与常规炎症指标的相关性及对老年膝骨关节置换术后PJI的预测价值.结果研究组术后1、3、5d血清G-CSF、suPAR、IL-1β水平高于对照组(P<0.05);研究组术后1、3、5 d常规炎症指标CRP、WBC、ESR水平高于对照组(P<0.05);老年膝骨关节置换术后PJI患者血清G-CSF、suPAR、IL-1β与常规感染指标CRP、WBC、ESR呈正相关(P<0.05);受试者工作特征(ROC)曲线分析结果显示,血清G-CSF、suPAR、IL-1β单一及联合预测老年膝骨关节置换术后PJI的AUC分别为0.777、0.843、0.721和0.948.结论老年膝骨关节置换术后PJI患者血清G-CSF、suPAR、IL-1β水平升高,三者联合检测对患者PJI具有较高的预测价值.

OBJECTIVE To investigate the predictive value of serum granulocyte colony-stimulating factor(G-CSF),soluble urokinase-type plasminogen activator receptor(suPAR)and interleukinin-1β(IL-1β)levels in periprosthesis infection(PJI)after knee joint replacement in elderly patients.METHODS A total of 80 elderly pa-tients with PJI after knee joint replacement treated in Huamu Community Health Service Center in Pudong New Area from Aug 2016 to Aug 2023 were enrolled as the study group,and 80 patients without PJI after senile knee joint replace-ment during the same period were included as the control group in a 1∶1 case-control study.Serum levels of G-CSF,su-PAR,IL-1β,C-reactive protein(CRP),white blood cell count(WBC)and erythrocyte precipitation rate(ESR)were de-tected in the two groups,and their correlation with conventional inflammatory indicators and predictive value in PJI after knee joint replacement were analyzed.RESULTS The levels of G-CSF,suPAR and IL-1βin the study group were higher than those in the control group 1,3 and 5 days after operation(P<0.05).The levels of CRP,WBC and ESR in the study group were higher than those in the control group on the 1st,3rd and 5th day after surgery(P<0.05).Serum G-CSF,suPAR and IL-1βlevels were positively correlated with CRP,WBC and ESR indexes in patients with knee osteoar-thritis after replacement(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the AUCs of se-rum G-CSF,suPAR and IL-1βwere 0.777,0.843,0.721 and 0.948,respectively.CONCLUSION Serum G-CSF,su-PAR and IL-1βlevels increase in patients with knee osteoarthritis after replacement,and the combined detection of G-CSF,SUPAR and IL-1βhas high predictive value in elderly patients with PJI.