Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany.
Hospital Universitario 12 de Octubre, Madrid, Spain.
J Orthop Surg Res. 2020 Oct 2;15(1):450. doi: 10.1186/s13018-020-01864-7.
Because there is no single gold standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection appears to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic value of serum interleukin (IL)-6 and C-reactive protein (CRP) for the diagnosis of PJI.
PubMed, Embase, and the Web of Science databases were searched for articles describing PJI diagnosis using serum IL-6 and CRP published between January 1990 and December 2019.
Eight studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% confidence interval [CI], 0.80-0.88) for the combined method (serum IL-6 and CRP) in series and parallel approaches, 0.87 (95% CI, 0.82-0.90) for IL-6, and 0.84 (95% CI, 0.79-0.88) for CRP. The pooled specificity was 0.85 (95% CI, 0.82-0.88) for the combined method, 0.83 (95% CI, 0.79-0.87) for IL-6, and 0.83 (95% CI, 0.79-0.87) for CRP. The combined method had the highest value for the area under the curve (0.9453), followed by IL-6 (0.9237) and CRP (0.9074). Subgroup analyses showed that the sensitivity of the combined method in parallel tests was higher than that in IL-6 or CRP (94% vs. 89% and 84%, respectively). Serial testing of the combined method showed increased specificity compared to a single indicator (96% vs. 83% and 80%).
The combination of serum IL-6 and CRP was a reliable tool for the diagnosis of periprosthetic hip and knee infection, demonstrating a better diagnostic accuracy than single marker analysis.
由于目前尚无诊断人工关节假体周围感染（PJI）的单一金标准方法，因此联合应用多种有价值的方法评估感染似乎可以获得更好的诊断结果。本研究旨在评估血清白细胞介素（IL）-6 和 C 反应蛋白（CRP）用于诊断 PJI 的诊断价值。
检索 1990 年 1 月至 2019 年 12 月期间发表的使用血清 IL-6 和 CRP 诊断 PJI 的文章，检索数据库包括 PubMed、Embase 和 Web of Science。
共纳入 8 项研究进行荟萃分析。联合检测（血清 IL-6 和 CRP）在系列和并行检测中检测 PJI 的汇总敏感性分别为 0.84（95%置信区间[CI]，0.80-0.88）、0.87（95%CI，0.82-0.90）、0.84（95%CI，0.79-0.88），特异性分别为 0.85（95%CI，0.82-0.88）、0.83（95%CI，0.79-0.87）和 0.83（95%CI，0.79-0.87）。曲线下面积（AUC）最高的是联合检测（0.9453），其次是 IL-6（0.9237）和 CRP（0.9074）。亚组分析显示，并行检测中联合检测的敏感性高于 IL-6 或 CRP（94%比 89%和 84%），联合检测的系列检测特异性高于单一标志物（96%比 83%和 80%）。
血清 IL-6 和 CRP 的联合检测是一种可靠的人工髋关节和膝关节假体周围感染诊断工具，与单一标志物分析相比，其诊断准确性更高。
