关节液AD-1、SDF-1、sICAM-1对人工肱骨头置换术术后感染的诊断价值及与术后康复的关系  

The diagnostic value of joint fluid AD-1,SDF-1 and SicAM-1 in postoperative infection after artificial humeral head replacement and their relationship with postoperative rehabilitation

作　　者：徐兵[1] 汪华清 黄强开 肖强 刘艳[1] 吴飞鹏[2] 虎琼华[3] XU Bing;WANG Huaqing;HUANG Qiangkai;XIAO Qiang;LIU Yan;WU Feipeng;HU Qionghua(Department of Orthopaedics,Chengdu Second People's Hospital,Chengdu,Sichuan,China,610017;Department of Orthopaedics,Panzhihua Central Hospital,Panzhihua,Sichuan,China,617067;Department of ICU,Chengdu Second People's Hospital,Chengdu,Sichuan,China,610017)

机构地区：[1]成都市第二人民医院骨科,四川成都610017 [2]攀枝花市中心医院骨科,四川攀枝花617067 [3]成都市第二人民医院ICU,四川成都610017

出　　处：《分子诊断与治疗杂志》2020年第8期1124-1128,共5页Journal of Molecular Diagnostics and Therapy

基　　金：成都市医学科研课题项目(2018033)。

摘　　要：目的探讨关节液α防御素-1(AD-1)、基质细胞衍生因子1(SDF-1)、可溶性细胞间黏附分子-1(sICAM-1)对人工肱骨头置换术术后感染的诊断价值,以及与愈合时间、肩关节功能的关系。方法选取本院42例人工肱骨头置换术术后感染患者作为研究组,另选同期86例人工肱骨头置换术术后未感染患者作为对照组。检测对比两组关节液AD-1、SDF-1、sICAM-1水平,分析关节液各指标对术后感染的诊断价值,以及关节液各指标与愈合时间、Neer评分的关系。结果研究组关节液AD-1、SDF-1、sICAM-1水平高于对照组(P<0.05);三者联合诊断人工肱骨头置换术术后感染具有较高的敏感性(73.81%)、特异性(91.86%),且AUC高达0.882;此外,关节液中的AD-1、SDF-1、sICAM-1与愈合时间存在显著正相关关系(r=0.623、0.477、0.490,P<0.05),与Neer评分存在显著负相关关系(r=-0.826、-0.794、-0.747,P<0.05)。结论AD-1、SDF-1、sICAM-1与人工肱骨头置换术术后感染的发生密切相关,三者联合诊断在人工肱骨头置换术术后感染诊断方面具有较高的临床诊断价值,且与感染患者愈合时间、肩关节功能存在密切相关性,有助于评估感染患者预后。Objective To investigate the diagnostic value of joint fluid defencin-1(AD-1),stromal cell derived factor 1(SDF-1),and soluble intercellular adhesion molecule sicAM-1(SICAM-1)in postoperative infection after artificial humeral head replacement,and their relationship with healing time and shoulder joint function.Methods 42 patients infected with artificial humeral head replacement in our hospital were selected as the study group,and 86 patients without infection after artificial humeral head replacement during the same period were selected as the control group.Detecting and comparing the levels of AD-1,SDF-1,and sICAM-1 in joint fluid between the two groups,and analyzing the diagnostic value of joint fluid indicators for postoperative infection and the relationship between the indexes of joint fluid and healing time and Neer score.Results The levels of joint fluid AD-1,SDF-1,and sICAM-1 in the study group were higher than those inthe control group(P<0.05);the AUC of postoperative infection after joint diagnosis of joint fluid indicators was as high as 0.882,the best diagnostic sensitivity was 73.81%,and the specificity was 91.86%;the joint fluid AD-1,SDF-1 and sICAM-1 had a significant positive correlation with healing time(r=0.623,0.477,0.490,P<0.05)and a negative correlation with Neer score(r=-0.826,-0.794,-0.747,P<0.05).Conclusion AD-1,SDF-1 and sICAM-1 are closely related to the occurrence of infection after artificial humeral head replacement.The combination of the three indicators has a high application value in the diagnosis of postoperative infection,and is closely related to the healing time of the infected patients and the function of the shoulder joint,which is helpful to assess the prognosis of infected patients.

关 键 词：人工肱骨头置换术 感染 α防御素-1 基质细胞衍生因子1 可溶性细胞间黏附分子-1 

分 类 号：R687.3[医药卫生—骨科学]