血清可溶性细胞间黏附分子-1及皮肤温度对全膝关节置换假体周围感染的诊断作用

Value of serum soluble intercellular adhesion molecule-1 and skin temperature in diagnosis of postoperative periprosthetic infection in total knee arthroplasty patients

目的探讨血清可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,SiCAM-1)和膝关节皮肤温度对诊断全膝关节置换术后假体周围感染的价值。方法选取2014年2月-2018年2月于江西省赣南医学院第一附属医院行全膝关节置换手术患者187例为研究对象,其中术后出现假体周围感染患者60例为感染组,同期术后未出现感染患者60例为未感染组。比较两组患者红细胞降沉率(erythrocyte sedimentation rate,ESR)、白细胞介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)、SiCAM-1及膝关节皮肤温度;采用Pearson相关性分析患者SiCAM-1指标及膝关节皮肤温度与患者ESR、IL-6、CRP的相关性。结果感染组患者ESR、IL-6、CRP、SiCAM-1指标水平及膝关节皮肤温度均高于对照组(P<0.05);SiCAM-1水平及膝关节皮肤温度与ESR、IL-6、CRP水平均呈正相关关系(P<0.05)。结论全膝关节置换术后假体周围感染患者SiCAM-1水平及膝关节皮肤温度与患者ESR、IL-6、CRP水平呈正相关性,联合诊断可提示感染。

OBJECTIVE To explore the value of serum soluble intercellular adhesion molecule-1(SiCAM-1)and knee skin temperature in diagnosis of postoperative periprosthetic infection in the total knee arthroplasty patients.METHODS A total of 187 patients who received the total knee arthroplasty in the First Affiliated Hospital of Gannan Medical College from Feb 2014 to Feb 2018 were recruited as the study objects,60 patients who had postoperative periprosthetic infection were assigned as the infection group,and 60 patients who did not have postoperative infection were set as the non-infection group.The erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),C-reactive protein(CRP),SiCAM-1 and knee skin temperature were compared between the two groups of patients.The correlation between the SiCAM-1,knee skin temperature and the ESR,IL-6 and CRP was observed by means of Pearson correlation analysis.RESULTS The levels of ESR,IL-6,CRP and SiCAM-1 as well as the knee skin temperature were significantly higher in the infection group than in the control group(P<0.05).The SiCAM-1 level and knee skin temperature were positively correlated with the levels of ESR,IL-6 and CRP(P<0.05).CONCLUSION The SiCAM-1 level and knee skin temperature of the total knee arthroplasty patients with postoperative periprosthetic infection are positively correlated with the levels of ESR,IL-6 and CRP,and the combined diagnosis may indicate the infection.