联合检测血沉、C-反应蛋白及降钙素原在关节置换术后感染的临床意义

摘要

Objective To discuss the clinical significance of combined detection of erythrocyte sedimentation rate, C-reac-tive protein and procalcitonin in diagnosis of the infection after joint replacement. Methods 59 cases of patients with joint replacement collected from January 2015 to January 2016 were selected and divided into the postoperative infection group and postoperative non-infection group according to the infection of postoperative patients, the ESR, CRP and PCT values in blood were monitored before operation and on 1d, 4d, 7d and 10d after treatment, and were compared with those in the healthy control group. Results The differences in the ESR, CRP and PCT levels in postoperative 1d between the infection group and non-infection group and the healthy control group had statistical significance(P<0.05), the differences in the ESR and CRP levels in postoperative 1d and 4d between the infection group and the non-infection group had no statistical sig-nificance(P>0.05), and the ESR and CRP levels in postoperative 7d and 10d in the infection group were obviously higher than those in the non-infection group,(P<0.05), but the PCT levels in postoperative 4d, 7d and 10d in the infection group were higher than those in the non-infection group, and the differences had statistical significance (P<0.05). The ROC curve analysis showed that the sensitivity and specificity of PCT in diagnosis of infection after joint replacement were respectively 88.2%and 81.0%, which were higher than those of ESR and CRP. Conclusion The infection after the joint replacement can lead to the increase of ESR, CRP and PCT, and the sensitivity and specificity of PCT detection are higher, and the com-bined detection of ESR, CRP and PCT can improve the diagnosis rate of early infection after the joint replacement.%目的：探讨血沉(ESR)、C-反应蛋白(CRP)以及血清降钙素原(PCT)联合检测在诊断关节置换术后感染的临床意义。方法整群选取2015年1月—2016年1月该院收治的59例关节置换术患者,根据术后患者感染情况其分为术后感染组与术后无感染组。分别于术前及术后第1、4、7、10天监测患者血液中ESR、CRP、PCT值,并与健康对照组进行比较。结果感染组与无感染组术后第1天ESR、CRP、PCT水平与健康对照组比较,差异有统计学意义(P<0.05)。感染组ESR与CRP水平在术后1,4天与未感染组差异无统计学意义(P>0.05),术后第7,10天则明显高于未感染组(P<0.05)。而感染组PCT水平在术后第4、7、10天均高于无感染组,且差异有统计学意义(P<0.05)。由ROC曲线分析可知,PCT对关节置换术后感染诊断的灵敏度为88.2%,特异性为81.0%,均高于ESR及CRP。结论关节置换术后感染可引起ESR、CRP及PCT的增高,其中PCT检测的灵敏度及特异性更高,联合监测ESR、CRP及PCT可提高关节置换术后早期感染的诊断率。