Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China.
BMC Musculoskelet Disord. 2024 Jan 2;25(1):24. doi: 10.1186/s12891-023-07142-x.
To evaluate the diagnostic values of serum platelet count (PC), mean platelet volume ratio (MPV), platelet count to mean platelet volume ratio (PVR), platelet to lymphocyte ratio (PLR), platelet to neutrophil ratio (PNR), PC/Albumin-globulin ratio (PC/AGR), and PC/C-reactive protein (PC/ CRP) in the diagnosis of periprosthetic joint infection (PJI).
The medical records were retrospectively analyzed of the 158 patients who had undergone hip or knee revisions from January 2018 to May 2022. Of them, 79 cases were diagnosed with PJI and 79 with aseptic loosening (AL). PJI was defined using the Musculoskeletal Infection Society criteria. The plasma levels of CRP, the erythrocyte sedimentation rate (ESR), PC, MPV, PVR, PLR, PNR, PC/AGR, and PC/CRP in the 2 groups were recorded and analyzed. In addition, tests were performed according to different joint types. The receiver operating characteristic curve was used to calculate the sensitivity and specificity of each indicator. The diagnostic value for each indicator was calculated according to the area under the curve (AUC).
The PC, PVR, PLR and PC/AGR levels in the PJI group were significantly higher than those in the AL group, while PC/CRP levels were significantly lower (P < 0.001). The AUC for PC/CRP, and PC/AGR was 0.804 and 0.802, respectively, which were slightly lower than that of CRP (0.826) and ESR (0.846). ROC analysis for PC/CRP, and PC/AGR revealed a cut-off value of 37.80 and 160.63, respectively, which provided a sensitivity of 73.42% and 84.81% and a specificity of 75.95% and 65.82% for PJI. The area under the curve of PLR and PC was 0.738 and 0.702. The area under the curve values for PVR, PNR, and MPV were 0.672, 0.553, and 0.544, respectively.
The results of this study suggest that PC, PLR, PC/CRP, and PC/AGR values do not offer significant advantages over ESR or CRP values when employed for the diagnosis of PJI. PVR, PNR, and MPV were not reliable in the diagnosis of PJI.
评估血清血小板计数（PC）、血小板平均体积比（MPV）、血小板计数与平均血小板体积比（PVR）、血小板与淋巴细胞比（PLR）、血小板与中性粒细胞比（PNR）、PC/白蛋白球蛋白比（PC/AGR）和 PC/C-反应蛋白（PC/CRP）在诊断假体周围关节感染（PJI）中的诊断价值。
回顾性分析了 2018 年 1 月至 2022 年 5 月期间因髋关节或膝关节翻修而接受治疗的 158 例患者的病历。其中，79 例诊断为 PJI，79 例诊断为无菌性松动（AL）。PJI 的定义采用肌肉骨骼感染学会标准。记录并分析了两组患者的 CRP、红细胞沉降率（ESR）、PC、MPV、PVR、PLR、PNR、PC/AGR 和 PC/CRP 血浆水平。此外，还根据不同的关节类型进行了检测。使用受试者工作特征曲线计算每个指标的灵敏度和特异性。根据曲线下面积（AUC）计算每个指标的诊断价值。
PJI 组的 PC、PVR、PLR 和 PC/AGR 水平明显高于 AL 组，而 PC/CRP 水平明显低于 AL 组（P < 0.001）。PC/CRP 和 PC/AGR 的 AUC 分别为 0.804 和 0.802，略低于 CRP（0.826）和 ESR（0.846）。PC/CRP 和 PC/AGR 的 ROC 分析显示，截断值分别为 37.80 和 160.63，对 PJI 的敏感性分别为 73.42%和 84.81%，特异性分别为 75.95%和 65.82%。PLR 和 PC 的 AUC 分别为 0.738 和 0.702。PVR、PNR 和 MPV 的 AUC 值分别为 0.672、0.553 和 0.544。
本研究结果表明，与 ESR 或 CRP 相比，PC、PLR、PC/CRP 和 PC/AGR 值在诊断 PJI 方面没有明显优势。PVR、PNR 和 MPV 不能可靠地诊断 PJI。
