Guerreiro Fransiska Dhyana, Mumith Aadil, Saeed Kordo
Queen Alexandra Hospital, Portsmouth Hospitals Trust, Portsmouth, England, United Kingdom.
Royal Hampshire County Hospital, Hampshire Hospital NHS Foundation Trust, Winchester, England, United Kingdom.
Infez Med. 2020 Mar 1;28(1):6-10.
There are still many unknowns regarding the potential application of Procalcitonin (PCT) as an adjunct to aid the diagnosis of Prosthetic Joint Infection. A systematic review searching scientific articles was performed with keywords "Procalcitonin", "Total Hip Replacement", and "Total Knee Replacement" (n=123). After review of the abstract and full text for relevance, ten articles were included (n=10). Serum PCT levels for chronic Total Hip Replacement (THR) and Total Knee Replacement (TKR) have a range of mean values from 1.5 ng/ml to 14.2 ng/ml. Specificity ranges from 0.27 to 0.98, while sensitivity is from 0.33 to 0.9. On primary THR/TKR with confirmation of non-infected status, serum PCT peaks between 1-3 days post-operatively, with peak levels varying from 0.12 - 0.79 ng/ml. Based on this review, serum PCT is not a good adjunct in diagnosing Prosthetic Joint Infection (PJI). Synovial fluid PCT fluid may add better clinical support but requires further studies. There were several limitations with this review: the studies are small and heterogeneous, there was a variable definition of PJI, and there was a wide range of mean values, sensitivity and specificity.
关于降钙素原（PCT）作为辅助手段用于人工关节感染诊断的潜在应用，仍有许多未知之处。我们使用关键词“降钙素原”、“全髋关节置换术”和“全膝关节置换术”进行了一项检索科学文章的系统综述（n = 123）。在审查摘要和全文的相关性后，纳入了10篇文章（n = 10）。慢性全髋关节置换术（THR）和全膝关节置换术（TKR）的血清PCT水平的平均值范围为1.5 ng/ml至14.2 ng/ml。特异性范围为0.27至0.98，而敏感性为0.33至0.9。在初次THR/TKR且确认无感染状态时，血清PCT在术后1 - 3天达到峰值，峰值水平在0.12 - 0.79 ng/ml之间变化。基于此综述，血清PCT并非诊断人工关节感染（PJI）的良好辅助手段。滑膜液PCT可能会提供更好的临床支持，但需要进一步研究。本综述存在几个局限性：研究规模小且异质性大，PJI的定义存在差异，平均值、敏感性和特异性的范围较宽。
