血清白蛋白与球蛋白比值、白蛋白和球蛋白在诊断人工关节周围感染和预测再植入后再感染中的潜在性能。

The potential performance of serum albumin to globulin ratio, albumin and globulin in the diagnosis of periprosthetic joint infection and prediction of reinfection following reimplantation.

机构信息

The First Clinical of Medical School, Guangzhou University of Chinese Medicine, NO.12 Jichang Road, District Baiyun, Guangzhou, 510405, Guangdong, China.

The First Department of Orthopedics, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, NO.90 Bayi Road, District Xihu, Nanchang, 330003, Jiangxi, China.

出版信息

BMC Musculoskelet Disord. 2022 Jul 30;23(1):730. doi: 10.1186/s12891-022-05533-0.

BACKGROUND

This study was conducted to evaluate the performance of serum albumin (ALB), globulin (GLO), and albumin to globulin ratio (AGR) in the diagnosis of PJI and prediction of reinfection following reimplantation in PJI patients who underwent two-stage revision.

METHODS

We perform a retrospective data collection on identified patients who underwent revision arthroplasties in our institution from January 2010 to January 2020. A total of 241 patients were stratified into: group A (PJI), group B (aseptic loosening). Fifty-five patients who underwent two-stage revision in group A were assigned to group C. Group C was stratified into subgroup 1 (reinfection) and subgroup 2 (non-reinfection). Receiver operating characteristic curves were used to evaluate the utility of serum markers for diagnosing PJI and predicting reinfection following reimplantation.

RESULTS

In the diagnosis of PJI, there were significant differences in the levels of ALB, GLO, and AGR between groups A and group B (P < 0.05). The AUC value of serum AGR (0.851) was similar to ESR (0.841) and CRP (0.866) (all p > 0.05). The AUC values of serum ALB and GLO were 0.757 and 0.753, respectively. As for predicting reinfection following reimplantation, the serum ALB in the non-reinfection group was higher than that in the reinfection group (p = 0.041). The AUC value of serum ALB was 0.7.

CONCLUSION

AGR was promising adjunct marker for the diagnosis of PJI, similar to CRP and ESR. ALB and GLO have an acceptable value for the diagnosis of PJI. ALB may be expected to be a kind of effective marker for predicting reinfection following reimplantation.

背景

本研究旨在评估血清白蛋白（ALB）、球蛋白（GLO）和白蛋白/球蛋白比值（AGR）在接受二期翻修的感染性关节置换术后患者中的表现，以诊断 PJI 和预测再感染。

方法

我们对 2010 年 1 月至 2020 年 1 月在我院接受翻修手术的患者进行回顾性数据收集。共有 241 名患者被分为：A 组（PJI）、B 组（无菌性松动）。A 组中有 55 名患者接受了二期翻修，被分为 C 组。C 组进一步分为亚组 1（再感染）和亚组 2（非再感染）。采用受试者工作特征曲线评估血清标志物对诊断 PJI 和预测再感染的价值。

结果

在诊断 PJI 时，A 组和 B 组之间的 ALB、GLO 和 AGR 水平存在显著差异（P<0.05）。血清 AGR（0.851）的 AUC 值与 ESR（0.841）和 CRP（0.866）相似（均 P>0.05）。血清 ALB 和 GLO 的 AUC 值分别为 0.757 和 0.753。至于预测再感染，非再感染组的血清 ALB 高于再感染组（p=0.041）。血清 ALB 的 AUC 值为 0.7。