初次单侧膝关节置换后膝关节局部皮温与C-反应蛋白、白细胞介素6、红细胞沉降率的关系  

Correlation of local skin temperature of knee joint with C-reactive protein,interleukin 6 and erythrocyte sedimentation rate after primary unilateral total knee arthroplasty

作　　者：臧文浩 宋健 滕学仁[3] 张其亮[3] Zang Wenhao;Song Jian;Teng Xueren;Zhang Qiliang(Shandong First Medical University, Taian 271000, Shandong Province, China;Department of Orthopedics, Rizhao City Juxian Hospital of Chinese Medicine, Rizhao 276800, Shandong Province, China;Department of Bone Joint and Sports Medicine, Eastern Branch of Qingdao Municipal Hospital, Qingdao 266000, Shandong Province, China)

机构地区：[1]山东第一医科大学,山东省泰安市271000 [2]日照市莒县中医医院骨科,山东省日照市276800 [3]青岛市市立医院东院区骨关节与运动医学科,山东省青岛市266000

出　　处：《中国组织工程研究》2019年第24期3773-3779,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:膝关节置换后假体周围感染是术后最为严重并发症之一,常引起局部皮肤温度升高,通过测量皮温进行监测便捷且易实施。目的:了解初次单侧膝关节置换后无并发症患者膝关节局部皮肤温度与C-反应蛋白、白细胞介素6、红细胞沉降率的关系。方法:选择2017年1月至2018年1月在青岛市市立医院骨关节科初次行单侧全膝关节置换的70例无并发症患者为研究对象。所有患者对治疗方案均知情同意,且得到医院伦理委员会批准。分别于术前1 d、术后1,3,6,9,12 d及术后1,2,3,6,9,12个月时测量其术膝及对侧健膝关节局部皮肤温度;术前、术后1,3,6,9,12 d及1,2,3个月采集空腹血液样本,检测其C-反应蛋白、白细胞介素6水平及红细胞沉降率,对所得数据进行统计学分析。结果与结论:①术后1,3,6,9,12 d及术后1,2,3,6个月术膝皮温显著高于术前及健膝(P <0.05),术后9,12个月时术膝皮温与术前及健侧差异无显著性意义(P> 0.05);术后第1天双膝平均温差达到峰值,并在随后9个月逐渐下降,术膝皮温在术后9个月时恢复至健膝水平;②术后1,3,6,9 d血液中白细胞介素6水平显著高于术前(P <0.05),术后12 d血液中白细胞介素6水平恢复至术前水平;术后1,3,6,9,12d血液中C-反应蛋白水平显著高于术前(P<0.05),术后1个月恢复至术前水平;白细胞介素6与C-反应蛋白均在术后1d达到峰值;③术后1,3,6,9,12d及术后1个月红细胞沉降率显著高于术前(P <0.05),至术后2个月恢复至术前水平;红细胞沉降率于术后第6天达到峰值;④提示在无并发症发生的全膝关节置换术后,术膝皮温、C-反应蛋白、白细胞介素6及红细胞沉降率在术后存在正常的波动,均于术后不同程度升高并随着时间延长逐渐下降直至恢复正常。可以通过检测皮温变化评估局部炎性反应的程度,因此对早期感染有一定监测作用。在没有其他明显术后感染迹象及血液BACKGROUND: Periprosthetic infection is a most serious complication after total knee arthroplasty. It often causes the increase of local skin temperature. Skin temperature measurement is convenient and easy to implement. OBJECTIVE: To understand the association of local skin temperature of the affected knee joint, with C-reactive protein, interleukin 6 and erythrocyte sedimentation rate after primary unilateral total knee arthroplasty without complications. METHODS: Seventy patients undergoing primary unilateral total knee arthroplasty without complications at Department of Bone and Joint, Qingdao Municipal Hospital from January 2017 to January 2018 were selected. Informed consents were obtained from all patients and the study was approved by the Ethics Committee of the hospital. The local skin temperatures of both knee joints were measured at preoperative 1 day, and postoperative 1, 3, 6, 9, and 12 days and 1, 2, 3, 6, 9, and 12 months. The fasting blood samples were collected at baseline and 1, 3, 6, 9, and 12 days and 1, 2, and 3 months postoperatively to detect the C-reactive protein, interleukin 6 and erythrocyte sedimentation rate. The data were analyzed statistically. RESULTS AND CONCLUSION:(1) Skin temperature of the affect knee at postoperative 1, 3, 6, 9, and 12 days and 1, 2, 3, and 6 months was significantly higher than the baseline and the healthy knee (P < 0.05), and showed no significant difference at postoperative 9 and 12 months (P > 0.05). Skin temperature of both knees reached a peak at 1 day postoperatively, which gradually declined in the following nine months and returned to normal at 9 months postoperatively.(2) The interleukin 6 level at 1, 3, 6, and 9 days postoperatively was higher than preoperatively (P < 0.05), and returned to normal at 12 days postoperatively. C-reactive protein level at 1, 3, 6, 9, and 12 days postoperatively was higher than preoperatively (P < 0.05), and returned to normal at 1 month postoperatively. Interleukin 6 and C-reactive protein levels both reached a peak at

关 键 词：膝关节置换 膝关节皮肤温度 术后感染 C-反应蛋白 白细胞介素6 红细胞沉降率 炎症反应 

分 类 号：R459.9[医药卫生—治疗学]