Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Street, XiCheng District, Beijing, 100034, People's Republic of China.
J Orthop Traumatol. 2022 Aug 1;23(1):36. doi: 10.1186/s10195-022-00657-4.
The diagnosis of periprosthetic joint infection (PJI) is challenging for clinicians, and the commonly used methods are too complicated and expensive for many clinical practices. The neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the platelet-to-mean-platelet-volume ratio (PVR), globulin (GLB), the albumin-to-globulin ratio (AGR), and the C-reactive protein (CRP)/AGR ratio are simple biomarkers for infection and can be easily determined from routine blood tests. Due to their low cost and ready availability in clinical practice, many clinicians have considered the diagnostic value of these biomarkers for PJI. The aim of our study is to determine the value of NLR, PLR, PVR, GLB, AGR, and CRP/AGR for the diagnosis of PJI.
One hundred sixty-four patients who received revision surgery after total knee or total hip replacements were enrolled, 47 in a PJI group and 117 in an aseptic failure group. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of NLR, PLR, PVR, GLB, AGR, and CRP/AGR for the diagnosis of PJI, and their performance levels were then compared with those of CRP and the erythrocyte sedimentation rate (ESR).
The levels of all tested biomarkers were significantly higher in patients with PJI (all P < 0.05). ROC analysis showed that CRP/AGR performed best in diagnosing PJI, with an area under curve (AUC) value of 0.902, and the AUCs of NLR (0.740), PLR (0.721), PVR (0.668), GLB (0.719), and AGR (0.767) were all lower than those for CRP (0.896) and ESR (0.829).
CRP/AGR was a valuable test for diagnosing PJI, but other novel biomarkers had only limited diagnostic value.
Level III.
对于临床医生来说，假体周围关节感染（PJI）的诊断具有挑战性，常用方法对许多临床实践来说过于复杂和昂贵。中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、血小板与平均血小板体积比值（PVR）、球蛋白（GLB）、白蛋白与球蛋白比值（AGR）和 C 反应蛋白（CRP）/AGR 比值是感染的简单生物标志物，可从常规血液检查中轻松确定。由于其成本低且在临床实践中易于获得，许多临床医生都考虑了这些生物标志物对 PJI 的诊断价值。我们的研究旨在确定 NLR、PLR、PVR、GLB、AGR 和 CRP/AGR 对 PJI 诊断的价值。
共纳入 164 例接受全膝关节或全髋关节翻修手术的患者，其中 PJI 组 47 例，无菌性失败组 117 例。采用受试者工作特征（ROC）分析评估 NLR、PLR、PVR、GLB、AGR 和 CRP/AGR 对 PJI 诊断的性能，并与 CRP 和红细胞沉降率（ESR）进行比较。
所有检测生物标志物在 PJI 患者中的水平均显著升高（均 P<0.05）。ROC 分析显示，CRP/AGR 在诊断 PJI 方面表现最佳，曲线下面积（AUC）值为 0.902，NLR（0.740）、PLR（0.721）、PVR（0.668）、GLB（0.719）和 AGR（0.767）的 AUC 均低于 CRP（0.896）和 ESR（0.829）。
CRP/AGR 是诊断 PJI 的一项有价值的检测，但其他新型生物标志物的诊断价值有限。
III 级。
