血清ESR、CRP水平及关节液WBC计数、IL-6水平在前交叉韧带重建术后关节内急性感染诊断中的价值分析  

Value analysis of detection of serum ESR,CRP,joint fluid WBC count and IL-6 in the diagnosis of acute intra-articular infection after anterior cruciate ligament reconstruction

作　　者：李强[1] 范志航 胡勇[1] 程松苗 LI Qiang;FAN Zhi-hang;HU Yong;CHENG Song-miao(Department of Knee Sports Injury,Sichuan Province Orthopedic Hospital,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省骨科医院膝关节运动损伤科,四川成都610041

出　　处：《川北医学院学报》2023年第6期827-830,共4页Journal of North Sichuan Medical College

摘　　要：目的:探究血清红细胞沉降率(ESR)、C反应蛋白(CRP)及关节液白细胞(WBC)计数、白细胞介素6(IL-6)水平在前交叉韧带重建(ACLR)术后关节内急性感染诊断中的价值。方法:回顾性分析6125例行关节镜下ACLR术患者的临床资料,根据术后是否发生关节内急性感染分为感染组(n=35)与非感染组(n=6090)。比较两组患者一般资料、术前血清ESR、CRP及关节液WBC计数、IL-6水平,多因素Logistic回归分析ACLR术后关节内急性感染的影响因素,采用受试者工作特征(ROC)曲线分析血清ESR、CRP水平及关节液WBC计数、IL-6水平对ACL重建术后关节内急性感染的诊断价值。结果:两组患者年龄、性别、BMI、吸烟史、饮酒史、合并症、术中出血量比较,差异均无统计学意义(P>0.05);感染组手术时间、抗菌药使用种类≥3种占比、血清白蛋白水平均高于非感染组(P<0.05);感染组血清ESR、CRP水平及关节液WBC计数、IL-6水平均高于非感染组(P<0.05)。多因素Logistic回归分析显示,手术时间、血清ESR、CRP水平、关节液WBC计数、IL-6水平是影响ACLR术后关节内急性感染的危险因素(P<0.05)。ROC曲线分析显示,血清ESR、CRP水平及关节液WBC计数、IL-6水平单独及联合诊断ACLR术后关节内急性感染的敏感度分别为68.57%、82.86%、77.14%、85.71%、91.43%,特异度分别为68.60%、71.40%、45.69%、60.00%、61.80%,ROC曲线下面积(AUC)分别为0.764、0.835、0.650、0.781,联合诊断价值更高(P<0.05)。结论:术前患者血清ESR、CRP水平及关节液WBC计数、IL-6水平联合检测对ACLR术后关节内急性感染发生的诊断价值较好,可作为临床辅助性监测指标。Objective:To explore the value of detection of serum erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),joint fluid white blood cell(WBC)count and interleukin-6(IL-6)in the diagnosis of acute intra-articular infection after anterior cruciate ligament reconstruction(ACLR).Methods:The data of 6,125 patients who underwent arthroscopic ACLR were retrospectively analyzed.According to whether acute intra-articular infection occurred after surgery,the patients were divided into postoperative infection group(n=35)and non-infection group(n=6,090).The general clinical data,preoperative serum ESR,CRP,joint fluid WBC count and IL-6 were compared between the two groups of patients.Multivariate Logistic regression analysis was used to analyze the influencing factors of acute intra-articular infection after ACLR,and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum ESR,CRP,joint fluid WBC count and IL-6 on acute intra-articular infection after ACL reconstruction.Results:There were no statistically significant differences in age,gender,BMI,smoking history,drinking history,comorbidities and intraoperative blood loss between the two groups(P>0.05).The surgical time,the proportion of types of antimicrobial drug use≥3 and preoperative serum albumin level in infection group were longer or higher than those in non-infection group(P<0.05).The levels of serum ESR,CRP,joint fluid WBC count and IL-6 were higher in infection group than those in non-infection group(P<0.05).Multivariate Logistic regression analysis showed that surgical time,serum ESR,CRP,joint fluid WBC count and IL-6 were risk factors of acute intra-articular infection after ACLR(P<0.05).ROC curve analysis revealed that the sensitivities of serum ESR,CRP,joint fluid WBC count and IL-6 alone and in combination in the diagnosis of acute intra-articular infection after ACLR were 68.57%,82.86%,77.14%,85.71%and 91.43%,and the specificities were 68.60%,71.40%,45.69%,60.00%and 61.80%,and the AUC s were 0.764,0.835,0.650 and

关 键 词：前交叉韧带重建术 关节内感染 关节液 诊断价值 

分 类 号：R687.2[医药卫生—骨科学]