Department of Orthopaedics, Balgrist University Hospital Zurich, Zurich, Switzerland.
Mediators Inflamm. 2013;2013:927636. doi: 10.1155/2013/927636. Epub 2013 May 13.
Procalcitonin (PCT) is a useful surrogate marker for the differentiation of postoperative infection and unspecific inflammatory reaction after surgery. It is known that postoperative course of the PCT serum level varies with type of surgery. No data exists about the postoperative course of serum PCT levels after primary total hip replacement (THR).
To characterize early postoperative serum PCT levels in uneventful primary THR compared to postoperative levels of different frequently used inflammatory blood parameters.
We prospectively investigated 31 patients. Blood samples were taken preoperatively and for 5 days postoperatively. PCT levels were compared with C-reactive protein (CRP), interleukin-6 (IL-6), and blood leucocyte counts (WBC).
In uneventful THR PCT levels showed a uniform low-level course with a peak at the second postoperative day. At the fifth day values returned to almost preoperative levels. On contrary, CRP levels remained high during the entire observational period. Only IL-6 levels showed a peak at postoperative day one with a quick and uniform return to preoperative levels.
Similar to observations in cardiothoracic, intestinal, and neural surgeries, postoperative course of PCT after primary THR showed a uniform low-level course with a peak at the second postoperative day but below expected levels in systemic infections.
降钙素原 (PCT) 是术后感染和手术后继发非特异性炎症反应鉴别诊断的有用替代标志物。众所周知,手术后 PCT 血清水平的变化与手术类型有关。目前尚无关于初次全髋关节置换术 (THR) 后 PCT 血清水平的术后过程的相关数据。
与术后常用的炎症血液参数相比,分析初次 THR 术后 PCT 血清水平的早期变化。
我们前瞻性地研究了 31 例患者。在术前和术后 5 天采集血样。比较 PCT 与 C 反应蛋白 (CRP)、白细胞介素-6 (IL-6) 和白细胞计数 (WBC)。
初次 THR 术后 PCT 水平呈均匀低水平趋势,术后第 2 天达峰值。第 5 天,PCT 水平几乎恢复到术前水平。相比之下,CRP 水平在整个观察期内一直保持较高水平。只有 IL-6 水平在术后第 1 天达到峰值,随后迅速降至术前水平。
与心胸、肠道和神经外科手术中的观察结果类似,初次 THR 术后 PCT 水平呈均匀低水平趋势,第 2 天达峰值,但低于全身性感染时的预期水平。