基于前白蛋白的比率标志物在人工关节周围感染诊断中的作用。

The role of ratio markers based on prealbumin in the diagnosis of periprosthetic joint infection.

作者信息

Cao Qianqian, Ning Xinchuang, Fan Panlong, Cheng Tianmiao, Zhang Yuzhe, Cheng Cheng, Dai Zhipeng

机构信息

Department of Orthopaedics, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China.

Department of Orthopaedics, Xinxiang Medical University, Xinxiang, Henan, China.

出版信息

Front Cell Infect Microbiol. 2025 Jul 8;15:1597401. doi: 10.3389/fcimb.2025.1597401. eCollection 2025.

DOI:10.3389/fcimb.2025.1597401

PMID:40697817

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12279772/

Abstract

BACKGROUND

Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty, and the timeliness of its diagnosis and treatment is crucial for patient recovery. Although various biomarkers have been extensively evaluated and applied in clinical practice, the diagnosis of PJI remains challenging. Therefore, it is necessary to identify more precise biomarkers for the diagnosis of PJI. This study aims to investigate the value of ratio-based biomarkers using prealbumin (PA) for the diagnosis of PJI.

METHODS

This study compared the levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen (FIB), PA, CRP/PA (CPR), ESR/PA (EPR), FIB/PA (FPR), and the combined ratio of CPR+EPR+FPR(CEF) in 180 patients with PJI and 105 patients with aseptic loosening (AL) who presented at our department from January 2019 to December 2024. The diagnostic efficacy of these markers in PJI diagnosis was assessed using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

RESULTS

Among these biomarkers, CPR has the highest AUC of 0.921 (95%CI 0.890-0.952), and it can distinguish PJI with a cut-off value of 0.0366, a sensitivity of 76.1%, and a specificity of 95.2%. In the diabetic subgroup, the combined biomarker CEF has an AUC of 0.951 for diagnosing PJI, with a sensitivity of 88.9% and a specificity of 94.4%.

CONCLUSION

Ratio-based markers based on PA show promise as valuable new adjunctive diagnostic markers for PJI.

摘要

背景

人工关节周围感染（PJI）是全关节置换术后的一种严重并发症，其诊断和治疗的及时性对患者康复至关重要。尽管各种生物标志物已在临床实践中得到广泛评估和应用，但PJI的诊断仍具有挑战性。因此，有必要识别出更精确的PJI诊断生物标志物。本研究旨在探讨使用前白蛋白（PA）的基于比值的生物标志物对PJI的诊断价值。

方法

本研究比较了2019年1月至2024年12月在我科就诊的180例PJI患者和105例无菌性松动（AL）患者的C反应蛋白（CRP）、红细胞沉降率（ESR）、纤维蛋白原（FIB）、PA、CRP/PA（CPR）、ESR/PA（EPR）、FIB/PA（FPR）以及CPR+EPR+FPR（CEF）的联合比值水平。使用受试者操作特征（ROC）曲线的曲线下面积（AUC）评估这些标志物在PJI诊断中的诊断效能。