人工关节周围感染中血液炎症与凝血标志物比值的诊断价值
Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection.
作者信息
Huang Jincheng, Li Xu, Chen Yajun, Zhang Meng, Gao Zongyan, Dai Zhipeng, Liu Tao, Jin Yi
机构信息
Department of Orthopedics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, P. R. China.
Department of SICU, Zhengzhou First People's Hospital, Zhengzhou, Henan, 450000, P. R. China.
出版信息
Open Med (Wars). 2025 Feb 27;20(1):20251150. doi: 10.1515/med-2025-1150. eCollection 2025.
INTRODUCTION
Assess the feasibility of utilizing the ratio of blood inflammation to coagulation markers as a potential periprosthetic joint infection (PJI) diagnostic tool.
MATERIALS AND METHODS
A retrospective analysis was conducted, involving 133 PJI and 93 aseptic loosening patients. Levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet count, mean platelet volume, fibrinogen, D-dimer, and ratios of CRP to fibrinogen, ESR to fibrinogen, platelet count and mean platelet volume ratio (PC/MPV), and D-dimer were compared. Receiver operating characteristic curves and Youden's index were employed to assess the diagnostic efficacy of these biomarkers.
RESULTS
PJI patients had significantly higher levels of CRP, ESR, PC/MPV ratio, fibrinogen, D-dimer, CRP/(PC/MPV) ratio (CPR), CRP/D-dimer, CRP/fibrinogen (CFR), ESR/(PC/MPV) ratio, ESR/D-dimer, and ESR/fibrinogen. Area under the curve (AUC) values for fibrinogen, CRP, and ESR in diagnosing PJI were comparable. AUC values for CPR and CFR were akin to those of ESR. AUC values for combined CRP and CPR, combined CRP and fibrinogen, combined CRP and CFR, and combined ESR and fibrinogen in diagnosing PJI were akin to that of combined CRP and ESR.
CONCLUSIONS
Fibrinogen, CPR, CFR, combined CRP and CPR, combined CRP and fibrinogen, combined CRP and CFR, and combined ESR and fibrinogen could be considered as new adjunct markers for diagnosing PJI.
引言
评估利用血液炎症与凝血标志物的比值作为假体周围关节感染（PJI）潜在诊断工具的可行性。
材料与方法
进行回顾性分析，纳入133例PJI患者和93例无菌性松动患者。比较C反应蛋白（CRP）、红细胞沉降率（ESR）、血小板计数、平均血小板体积、纤维蛋白原、D-二聚体水平，以及CRP与纤维蛋白原的比值、ESR与纤维蛋白原的比值、血小板计数与平均血小板体积比值（PC/MPV）和D-二聚体。采用受试者工作特征曲线和尤登指数评估这些生物标志物的诊断效能。
结果
PJI患者的CRP、ESR、PC/MPV比值、纤维蛋白原、D-二聚体、CRP/（PC/MPV）比值（CPR）、CRP/D-二聚体、CRP/纤维蛋白原（CFR）、ESR/（PC/MPV）比值、ESR/D-二聚体和ESR/纤维蛋白原水平显著更高。纤维蛋白原、CRP和ESR诊断PJI的曲线下面积（AUC）值相当。CPR和CFR的AUC值与ESR的相似。CRP与CPR联合、CRP与纤维蛋白原联合、CRP与CFR联合以及ESR与纤维蛋白原联合诊断PJI的AUC值与CRP和ESR联合的相似。
结论
纤维蛋白原、CPR、CFR、CRP与CPR联合、CRP与纤维蛋白原联合、CRP与CFR联合以及ESR与纤维蛋白原联合可被视为诊断PJI的新辅助标志物。
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