CRP与ESR在骨科内固定手术后的表达变化及意义  

Change and Clinical Significance of CRP and ESR After Internal Fixation for Fracture

作　　者：黄凯[1] 

机构地区：[1]四川省内江市第一人民医院骨科,四川内江641000

出　　处：《标记免疫分析与临床》2016年第8期874-877,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨C反应蛋白(C-reaction protein,CRP)与红细胞沉降率(erythrocyte sedimentation rate,ESR)在骨科内固定手术后的表达变化及意义。方法选取87例骨科内固定手术患者作为研究对象,其中38例患者术后感染作为感染组,另外49例患者术后无感染作为非感染组;于术前、术后1、3、7、14天时,检测所有患者的CRP与ESR表达水平,分析骨科内固定手术后感染患者的CRP与ESR表达变化规律;并对比感染组与非感染组患者的CRP与ESR峰值、CRP表达水平异常率、ESR表达水平异常率。结果 38例骨科内固定手术后感染患者,术后14天内的CRP与ESR表达水平均显著高于术前水平,呈递增式变化;49例骨科内固定手术后非感染患者,术后CRP与ESR表达水平呈先递增后递减式变化,且术后3天CRP表达水平、术后7天ESR表达水平均显著高于术前水平(P<0.05);感染组患者术后CRP与ESR峰值、CRP表达水平异常率、ESR表达水平异常率均显著大于非感染组(P<0.05);将CRP、ESR联合考虑,任一指标超过阈值则诊断感染,两项指标均未超过阈值则排除感染,则对骨科内固定手术后感染诊断的灵敏度为99.00%,特异度为97.00%。结论骨科内固定手术后CRP与ESR的表达水平均呈先递增后递减的规律性变化,通过监测CRP与ESR的表达变化,有利于早期感染的发现,且CRP比ESR更敏感,两者均可作为评估术后感染发生风险、病情严重程度、疗效及预后的观察指标。Objective To investigate the C-reactive protein（CRP） and erythrocyte sedimentation rate（ESR）changeand significance of post-operative（post-op） fixation in orthopedics.Methods A total of 87 cases of patients undergoing orthopedic fixation were selected for the study,including 38 patients with postoperative infection as infection group,another 49 patients without postoperative infection of non-infected group.CRP and ESR were detected and analyzed preoperative and postoperative day 1,day 3,day 7 and day 14.CRP and ESR level changes,pattern and peak value were observed and compared.Results CRP and ESR levels were significantly higher in infection group on post-op day 14 than the preoperative levels and showed increasing changes after fixation.CRP and ESR showed increasing changes in non-infected group post-op day1.CRP level on post-op day 3 and ESR level on post-op day 7 were significantly higher than pre-op level in noninfected group（P〈0.05）.The over expression of CRP and abnormal ESR,the peak levels of changes in infection group were significantly higher than that of non-infected group（P〈0.05）.When both CRP and ESR were used as indicators for infection diagnosis,infection couldbe excluded if both indicators did not exceed the threshold values,whereas when one of them reached abnormal level,possible infection should be highly suspected.The diagnostic sensitivity was 99.00% and specificity of 97.00% for infection after fixation of orthopedic surgery.Conclusion CRP expression and ESR exhibited a pattern change after internal orthopedic fixation,which was ascending first and descending afterwards.Monitoring changes of CRP and ESR can detect early infection.CPR is more sensitive than ESR.Both CPR and ESR can be used to assess the risk of postoperative infection,severity,treatment efficacy and prognosis.

关 键 词：骨科内固定手术 C反应蛋白 红细胞沉降率 

分 类 号：R687.3[医药卫生—骨科学]