原发性全髋关节和膝关节置换术中降钙素原的模式及其在假体周围感染中的意义。
The pattern of procalcitonin in primary total hip and knee arthroplasty and its implication in periprosthetic infection.
作者信息
Ali Syed, Christie Andrew, Chapel Andrew
机构信息
SHO 3 Orthopaedics, Inverclyde Royal InfirmaryHospital, Greenock., PA16 0XN, Glsgow, U.K.
出版信息
J Clin Med Res. 2009 Jun;1(2):90-4. doi: 10.4021/jocmr2009.04.1236. Epub 2009 May 20.
BACKGROUND
The serum marker Procalcitonin (PCT) has been shown to be a sensitive indicator of bacterial infection, but very little is known of its behavior in periprosthetic infection. In this study, PCT was compared with standard tests used to aid the diagnosis of infection. As a baseline, its pattern in uncomplicated hip and knee arthroplasty was investigated.
METHODS
A prospective study of fifty-nine patients had bloods taken preoperatively, and on days 1, 3, 5, for PCT, C- reactive protein, erythrocyte sedimentation rate and white cell count.
RESULTS
Fifty patients (85%) had normal PCT values (< 0.5 ng/ml) and only 5 recorded a value > 1.0ng/ml. On day 5 only 1 patient had a value > 0.5ng/ml. The standard tests all showed sporadic elevations over the 3 days. PCT levels are not significantly elevated by the trauma of this surgery, as they are in other surgical procedures.
CONCLUSIONS
PCT may be very useful in patients with suspected periprosthetic infection.
KEYWORDS
Infection; Periprosthetic; Procalcitonin; C-reactive protein; Arthroplasty.
背景
血清标志物降钙素原（PCT）已被证明是细菌感染的敏感指标，但对于其在假体周围感染中的表现知之甚少。在本研究中，将PCT与用于辅助诊断感染的标准检测方法进行了比较。作为基线，研究了其在单纯性髋关节和膝关节置换术中的变化模式。
方法
对59例患者进行前瞻性研究，在术前、术后第1天、第3天和第5天采集血液，检测PCT、C反应蛋白、红细胞沉降率和白细胞计数。
结果
50例患者（85%）的PCT值正常（<0.5 ng/ml），只有5例的PCT值>1.0 ng/ml。在第5天，只有1例患者的PCT值>0.5 ng/ml。标准检测在这3天内均显示出散发性升高。与其他外科手术不同，该手术创伤并未使PCT水平显著升高。
结论
PCT对于疑似假体周围感染的患者可能非常有用。
关键词
感染；假体周围；降钙素原；C反应蛋白；关节置换术
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