红细胞沉降率（ESR）和C反应蛋白（CRP）在人工关节周围感染二期翻修的各阶段之间具有参考价值。
ESR and CRP are useful between stages of 2-stage revision for periprosthetic joint infection.
作者信息
Lindsay Christopher P, Olcott Christopher W, Del Gaizo Daniel J
机构信息
Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
出版信息
Arthroplast Today. 2017 Feb 4;3(3):183-186. doi: 10.1016/j.artd.2016.08.002. eCollection 2017 Sep.
BACKGROUND
Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important tests in the initial diagnosis of periprosthetic joint infection. Many surgeons also use these tests to determine if infection has resolved between stages of a 2-stage procedure, but little data exist regarding this practice.
METHODS
A retrospective review of our institutional total joint databases was conducted to determine sensitivity, specificity, and predictive values of elevated ESR and/or CRP to diagnose persistent infection between stages.
RESULTS
Among 16 knees and 5 hips, sensitivity was 50% for CRP, 75% for ESR, and 100% when combined. The negative predictive value of persistent infection was 100% when neither test was elevated.
CONCLUSIONS
Results of this study support the use of CRP and ESR as indicators of the resolution of periprosthetic joint infection between stages of 2-stage revision.
背景
血清红细胞沉降率（ESR）和C反应蛋白（CRP）是人工关节周围感染初始诊断中的重要检查项目。许多外科医生也使用这些检查来确定在两阶段手术的各阶段之间感染是否已消除，但关于这种做法的数据很少。
方法
对我们机构的全关节数据库进行回顾性分析，以确定ESR和/或CRP升高对诊断各阶段持续性感染的敏感性、特异性和预测价值。
结果
在16例膝关节和5例髋关节中，CRP的敏感性为50%，ESR为75%，两者联合时为100%。当两项检查均未升高时，持续性感染的阴性预测值为100%。
结论
本研究结果支持将CRP和ESR用作两阶段翻修手术各阶段之间人工关节周围感染消除的指标。
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