Shih L Y, Wu J J, Yang D J
Department of Orthopedics and Traumatology, VGH, Taipei, Taiwan, Republic of China.
Clin Orthop Relat Res. 1987 Dec(225):238-46.
Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured serially in 50 osteoarthritic patients treated with uncomplicated primary total hip arthroplasties (THAs) and also in 28 patients with painful hip for different periods after THA. The follow-up period was one year. In uncomplicated primary THA, the ESR was slightly elevated before surgery and was variable after surgery; some patients continued to have abnormally high ESRs one year after surgery. However, CRP was normal before surgery and after surgery showed a distinctive pattern that rapidly normalized within three weeks. In patients with a painful hip after THA, ESR was elevated in those with septic loosening and variable in those with mechanical loosening; however, the difference was not significant. ESR after successful revision THA was also variable. CRP was high in patients with septic loosening and normal in those with mechanical loosening. Normalization of CRP was rapid after control of infection or within three weeks of successful revision THA. Uneventful recovery after THA is indicated by normalization of CRP within three weeks, regardless of ESR. Measurement of both ESR and CRP is helpful in differentiating septic and mechanical loosening, detecting complications, and monitoring the effects of treatment, but CRP is more informative and sensitive than ESR for these purposes.
对50例行单纯初次全髋关节置换术（THA）的骨关节炎患者以及28例THA术后不同时期出现髋关节疼痛的患者，连续测量其血清C反应蛋白（CRP）水平和红细胞沉降率（ESR）。随访期为1年。在单纯初次THA中，ESR在术前略有升高，术后变化不定；一些患者术后1年ESR仍异常升高。然而，CRP术前正常，术后呈现出一种独特模式，即在3周内迅速恢复正常。在THA术后出现髋关节疼痛的患者中，感染性松动患者的ESR升高，机械性松动患者的ESR变化不定；然而，差异不显著。翻修THA成功后ESR也变化不定。感染性松动患者的CRP升高，机械性松动患者的CRP正常。感染得到控制后或翻修THA成功后3周内，CRP迅速恢复正常。无论ESR如何，THA术后3周内CRP恢复正常表明恢复顺利。ESR和CRP的测量有助于区分感染性和机械性松动、检测并发症以及监测治疗效果，但在此方面CRP比ESR更具信息价值和敏感性。
