糖尿病与人工关节置换术后假体周围感染的相关性研究

摘要

Objective To investigate the effects of diabetes on prosthetic joint infection (PJI) after the artificial joint replacement. Methods Clinical data of 1799 patients who underwent primary total hip and knee arthroplasty from January 2010 to March 2016 in our hospital were selected for this retrospective cohort study. All patients were divided into the diabetes group (n =361) and control group (n =1438). Conditional Logistic regressions were run to calculate the odds ratios (ORs) and the 95％ confidence intervals (CIs). Results The risk of PJI for diabetic patients was 1.83 times (95％ CI: 1.01 - 3.32, P ＜ 0.05) higher than that for the non-diabetic patients. The risk was higher among the diabetic patients with bilateral artificial joint replacement (OR: 7.2; 95％ CI: 1.2 - 43.6; P ＜ 0.05) than the patients with unilateral artificial joint replacement (OR =1.9). Diabetic patients and patients with abnormal glucose tolerance took higher risks of PJI than patients with normal blood glucose by 7.5 times (95％ CI:1.4 - 38.7, P ＜ 0.05) and 5.8 times (95％ CI: 1.1 - 31.6, P ＜ 0.05), respectively. Conclusions Diabetes and abnormal glucose tolerance will statistically increase risks of PJI after the artificial joint replacement. PJI is more likely to occur in diabetic patients with bilateral artificial joint replacement.%目的 探讨糖尿病及糖耐量异常与人工关节置换术后假体周围感染(prosthetic joint infection, PJI)发病率的相关性.方法 选取2010年1月至2016年3月,于我院行初次人工全髋及全膝关节置换术共1799例患者的临床资料进行回顾性队列研究,糖尿病组361例,非糖尿病组1438例,通过Logistic回归分析来计算比值比.结果 相较于非糖尿病患者,糖尿病组患者PJI发生风险提高了1.83倍(95％ CI:1.01～3.32,P＜0.05).双侧同时行人工关节置换患者组中,糖尿病患者PJI发病率的OR值为7.2(95％ CI:1.2～43.6;P＜0.05),明显高于仅行单侧人工关节置换组患者(OR值为1.9).相较于血糖正常患者,糖尿病组患者及糖耐量异常患者PJI发生风险提高了7.5倍(95％ CI:1.4～38.7,P＜0.05)和5.8倍(95％ CI:1.1～31.6, P＜0.05).结论 糖尿病及糖耐量异常患者人工关节置换术后发生PJI的风险会显著增加,糖尿病患者双侧同时行人工关节置换时,更容易发生PJI.