可溶性细胞间粘附分子-1和白细胞介素-6在全膝关节置换术术后感染诊断中的意义  

Significance of soluble intercellular adhesion molecule-1 and interleukin-6 in diagnosis of postoperative infections in total knee arthroplasty patients

作　　者：林蔚[1] 洪伟力[2] 梁伟[3] 吴晓光[1] 吴伟东[1] 

机构地区：[1]丽水市中心医院关节外科,浙江丽水323000 [2]瑞安市人民医院急诊科,浙江瑞安325200 [3]丽水市人民医院,浙江丽水323000

出　　处：《中华医院感染学杂志》2017年第13期3017-3020,共4页Chinese Journal of Nosocomiology

基　　金：丽水市市级公益性技术应用研究基金资助项目(2013ZC020);浙江省医药卫生科研基金资助项目(2017KY725)

摘　　要：目的探讨可溶性细胞间粘附分子-1(SiCAM)和白细胞介素-6(IL-6)在全膝关节置换术术后感染诊断中的意义。方法选择2008年1月-2015年12月于医院进行全膝关节置换术术后感染患者52例为感染组和同期全膝关节置换术术后未感染患者52例为对照组;收集患者临床资料,测定双膝关节皮肤温度差和血清C-反应蛋白(CRP)、IL-6、SiCAM水平。结果感染组52例患者中共分离出病原菌51株,金黄色葡萄球菌、大肠埃希菌分别为15株、11株,构成比分别为29.41%、21.57%;对照组患者术后1d、7d、1月时双膝关节皮肤温度差均高于术前(P<0.05),术后6月时双膝关节皮肤温度差和术前比较差异无统计学意义;术后1d、7d时CRP和IL-6水平高于术前(P<0.05);术后各时段SiCAM水平和术前比较差异均无统计学意义;术后6月,感染组双膝关节皮肤温度差、CRP、IL-6、siCAM水平均高于对照组(P<0.05);术后6月双膝关节皮肤温度差、CRP与IL-6、siCAM水平均呈正相关(P<0.05)。结论全膝关节置换术后感染患者血清IL-6、siCAM水平升高,血清IL-6、siCAM水平在全膝关节置换术后感染的诊断中具有一定价值。OBJECTIVE To explore the significance of soluble intercellular adhesion molecule-1（SiCAM）and interleukin-6（IL-6）in diagnosis of postoperative infections in total knee arthroplasty patients.METHODS From Jan2008 to Dec 2015,a total of 52 patients who received total knee arthroplasty and had postoperative infections were chosen as the infection group,meanwhile,52 patients who received total knee arthroplasty but did not have postoperative infections were set as the control group.The clinical data were collected from the patients,and the knee joint skin temperature difference and the levels of serum C-reactive protein（CRP）,IL-6,and SiCAM were determined.RESULTS Totally 51 strains of pathogens were isolated from 52 patients in the infection group,of which 15（29.41%）were Staphylococcus aureus,and 11（21.57%）were Escherichia coli.The knee joint skin temperature difference of the control group was higher after the surgery for 1day,7days,and 1month than before the treatment（P〈0.05）,there was no significant difference in the knee joint skin temperature difference after the surgery for 6months and before the surgery;the levels of CRP and IL-6were higher after the surgery for 1day and 7days than before the surgery（P〈0.05）;there was no significant difference in the siCAM level after the surgery for different time periods and before the surgery.The knee joint skin temperature difference and the levels of CRP,IL-6,and siCAM were higher in the infection group than in the control group after the surgery for 6months（P〈0.05）;the knee joint skin temperature difference,CRP were positively correlated with the levels of IL-6and siCAM（P〈0.05）.CONCLUSIONThe levels of serum IL-6and siCAM are elevated in the total knee arthroplasty patients with postoperative infections,and the levels of serum IL-6and siCAM have certain value in diagnosis of postoperative infections in the total knee arthroplasty patients.

关 键 词：可溶性细胞间粘附分子-1 白细胞介素-6 全膝关节置换术 感染 

分 类 号：R619.3[医药卫生—外科学]