血清SAA/CRP对髋膝关节置换术后假体周围感染的预测价值

Predictive Value of Serum SAA/CRP for Prosthetic Joint Infection After Hip and Knee Replacement Surgery

目的探讨血清淀粉样蛋白A(SAA)/C反应蛋白(CRP)对髋膝关节置换术后假体周围感染(PJI)的预测价值。方法回顾性分析2017年1月至2022年12月在安阳市人民医院初次接受髋或膝关节置换术治疗的1158例患者的资料,将术后发生PJI的27例患者纳入感染组;经样本计算公式计算对照组样本量后,于未发生PJI的1131例患者中筛选符合条件的127例纳入未感染组。设计基线资料调查表统计研究所需资料,比较患者术前、术后第1天血清SAA、CRP水平,并计算SAA/CRP值,分析血清SAA/CRP对髋膝关节置换术后PJI的预测价值。结果感染组合并糖尿病、吸烟史及术前贫血占比高于未感染组(P<0.05);两组术后1 d血清SAA、CRP、SAA/CRP水平均较术前升高,且感染组SAA、SAA/CRP高于未感染组(P<0.05);两组术后1 d血清CRP水平差异无统计学意义(P>0.05);绘制受试者工作特征曲线,结果显示,SAA、SAA/CRP对髋膝关节置换术后PJI预测的曲线下面积分别为0.711、0.866,SAA/CRP预测价值优于SAA(χ^(2)=6.932,P<0.001)。结论PJI患者血清SAA/CRP值在髋膝关节置换术后表达上调,这种异常的表达上调对术后PJI的发生有理想预测价值。

Objective To explore the predictive value of serum amyloid A(SAA)/C-reactive protein(CRP)for prosthetic joint infection(PJI)after hip and knee replacement surgery.Methods A retrospective analysis was conducted on the data of 1158 patients who underwent hip or knee replacement surgery in Anyang People’s Hospital from January 2017 to December 2022.And 27 patients with postoperative PJI were included in the infected group.After calculating the sample size of the control group using the sample calculation formula,127 eligible patients were selected from 1131 patients who did not experience PJI and included in the uninfected group.The baseline data questionnaire was designed to collect the required data.The serum SAA and CRP levels were recorded and compared before operation and on the first day after operation,and the SAA/CRP ratio was calculated.The predictive value of serum SAA/CRP for PJI after hip and knee arthroplasty was analyzed.Results The proportion of diabetes,smoking history and preoperative anemia in the infected group were higher than those in the uninfected group(P<0.05).The serum levels of SAA,CRP and SAA/CRP in both groups increased on the 1st day after surgery compared to preoperative levels,and the levels of SAA and SAA/CRP in the infected group were higher than the uninfected group(P<0.05).There was no statistical difference in serum CRP levels between the two groups on the 1st day after surgery(P>0.05).The receiver operating characteristic curve was drawn,and the results showed that the area under the curve of SAA and SAA/CRP for predicting PJI after hip and knee replacement surgery were 0.711 and 0.866,respectively.The predictive value of SAA/CRP was better than SAA(χ^(2)=6.932,P<0.001).Conclusion The serum SAA/CRP ratio in PJI patients is upregulated after hip and knee replacement surgery,and this abnormal upregulation has ideal predictive value for the occurrence of postoperative PJI.