Hashimoto Kohei, Morishima Takkan, Watanabe Kazutaka, Ikemoto Tatsunori, Nakamura Yukio, Takahashi Nobunori
Department of Orthopedic Surgery, Aichi Medical University Hospital, Aichi Medical University, Nagakute 480-1195, Aichi, Japan.
Department of Orthopedic Surgery, Division of Osteoporosis, Locomotive Syndrome, Joint Disease Center, Aichi Medical University Hospital, Aichi Medical University, Nagakute 480-1195, Aichi, Japan.
J Clin Med. 2025 Jun 14;14(12):4246. doi: 10.3390/jcm14124246.
: The purpose of this study was to determine the normative perioperative plasmatic levels of presepsin in patients undergoing primary total hip arthroplasty (THA), and to evaluate whether presepsin measurements can effectively distinguish the presence of periprosthetic joint infection (PJI) following THA. : In study 1, we evaluated multiple inflammatory markers before and at several time points after surgery in 31 primary THA patients. The Kruskal-Wallis test was used to compare sequential changes in each variable followed by the Sheffe post hoc comparison. In study 2, we evaluated the diagnostic accuracy of the inflammatory markers for PJI using five cases with confirmed PJI without bacteremia. ROC curve analysis was performed comparing these PJI cases with the 31 preoperative cases from study 1. : In study 1, presepsin levels were not significantly different from the baseline throughout the monitoring period. In study 2, the AUCs of CRP (1.0, < 0.001) and ESR-1h (0.83, < 0.05) in the ROC curve were able to discriminate PJI, but those of presepsin (0.51, = 0.96) and WBC (0.65, = 0.28) failed to discriminate PJI. : Our findings suggest that presepsin levels remain stable following THA and may have limited utility in detecting periprosthetic joint infection, particularly in the absence of systemic infection.
本研究的目的是确定初次全髋关节置换术（THA）患者围手术期 presepsin 的血浆正常水平，并评估 presepsin 测量能否有效区分 THA 术后假体周围关节感染（PJI）的存在。：在研究 1 中，我们评估了 31 例初次 THA 患者手术前及术后几个时间点的多种炎症标志物。采用 Kruskal-Wallis 检验比较各变量的连续变化，随后进行谢费尔事后比较。在研究 2 中，我们使用 5 例确诊为无菌血症的 PJI 病例评估了炎症标志物对 PJI 的诊断准确性。将这些 PJI 病例与研究 1 中的 31 例术前病例进行比较，进行 ROC 曲线分析。：在研究 1 中，整个监测期内 presepsin 水平与基线无显著差异。在研究 2 中，ROC 曲线中 CRP（1.0，<0.001）和 ESR-1h（0.83，<0.05）的曲线下面积（AUC）能够区分 PJI，但 presepsin（0.51，=0.96）和白细胞（WBC，0.65，=0.28）的 AUC 未能区分 PJI。：我们的研究结果表明，THA 术后 presepsin 水平保持稳定，在检测假体周围关节感染方面可能效用有限，尤其是在无全身感染的情况下。
