平均轨迹误差、血清内毒素与CR假体全膝关节置换术后早期疗效的关系  

Relationship between average trajectory error and serum endotoxin with early efficacy after CR prosthesis total knee arthroplasty

作　　者：温振涛 温存宁 张莉[1] 方庆山[1] 李高强[1] 陈晓鹏[1] WEN Zhentao;WEN Cunning;ZHANG Li;FANG Qingshan;LI Gaoqiang;CHEN Xiaopeng(Second Department of Osteoarthritis,Handan Municipal First Hospital,Handan,Hebei 056000,China;Department of Emergency,Handan Municipal First Hospital,Handan,Hebei 056000,China)

机构地区：[1]河北省邯郸市第一医院骨关节二科,河北邯郸056000 [2]河北省邯郸市第一医院急诊科,河北邯郸056000

出　　处：《检验医学与临床》2024年第12期1739-1744,1749,共7页Laboratory Medicine and Clinic

基　　金：河北省医学科学课题计划项目(20231916);河北省邯郸市科学技术研究与发展项目(22422083048ZC)。

摘　　要：目的分析平均轨迹误差、血清内毒素与后交叉韧带保留型(CR)假体全膝关节置换术(TKA)后早期疗效的关系。方法收集2021年8月至2023年6月于邯郸市第一医院拟行TKA的膝骨关节炎(KOA)患者为研究对象,术后3个月时采用美国膝关节协会(AKS)评分和膝关节功能评分表(HSS)评分评估患者TKA后的早期疗效,同时收集患者基线资料,术后1、2、3个月时测定患者本体感觉(平均轨迹误差)、血清内毒素水平。分析平均轨迹误差、血清内毒素与患者CR假体TKA后早期疗效的关系。结果术后3个月时,100例患者中AKS评分<70分23例(23.00%),HSS评分<70分26例(26.00%)。重复测量方差分析显示,不同AKS评分患者及不同HSS评分患者血清内毒素水平、平均轨迹误差均存在组间效应、时间效应和交互效应(P<0.05),故进一步单独效应分析。两组术后2、3个月时血清内毒素水平、平均轨迹误差均低于术后1个月时(P<0.05)。多变量方差分析显示,AKS评分<70分者术后1、2、3个月时的血清内毒素水平、平均轨迹误差均高于AKS评分≥70分者(P<0.05),HSS评分<70分者术后1、2、3个月时的血清内毒素水平、平均轨迹误差均高于HSS评分≥70分者(P<0.05)。Pearson相关分析显示,平均轨迹误差、血清内毒素水平与AKS评分、HSS评分均呈负相关(r=-0.285~-0.206,P<0.05)。多因素Logistic回归分析显示,平均轨迹误差、血清内毒素是CR假体TKA后早期AKS评分≥70分或HSS评分≥70分的影响因素(P<0.05)。结论CR假体TKA后患者早期疗效与平均轨迹误差、血清内毒素存在一定关系。Objective To analyze the relationship between average trajectory error and serum endotoxin with early efficacy after posterior cruciate ligament retention type(CR)prosthetic total knee arthroplasty(TKA).Methods The patients with knee osteoarthritis(KOA)intended to undergo TKA in Handan Municipal First Hospital from August 2021 to June 2023 were collected as the research subjects.The American Knee Association(AKS)score and Knee Function Scale(HSS)score in postoperative 3 months were used to evaluate the early efficacy of the patients after TKA.Meanwhile the baseline data of the patients were collected,and the proprioception(mean trajectory error)and serum endotoxin level were measured in postoperative 1 month,2 months and 3 months.The relationship between average trajectory error and serum endotoxin with early efficacy of CR prosthesis TKA in the patients was analyzed.Results In postoperative 3 months,23 cases(23.00%)among 100 patients had the AKS score<70 points,26 cases(26.00%)had the HSS score<70 points.The repeated measures variance analysis showed that the serum endotoxin and mean trajectory error had the intergroup effect,time effect and interaction effect between the patients with different AKS scores and the patients with different HSS scores(P<0.05).The further separate effect analysis showed that serum endotoxin levels and average trajectory error in postoperative 2 months and 3 months were lower than those in postoperative 1 month(P<0.05).The multivariate variance analysis showed that the serum endotoxin level and average trajectory error in postoperative 1 month,2 months and 3 months in the patients with AKS score<70 points were higher than those in the patients with AKS score≥70 points,while the serum endotoxin levels and mean trajectory error in postoperative 1 month,2 months and 3 months in the patients with HSS scores<70 points were higher than those in the patients with HSS scores≥70 points(P<0.05).The Pearson correlation analysis results showed that the average trajectory error and serum endo

关 键 词：全膝关节置换术 后交叉韧带保留型 平均轨迹误差 内毒素 膝骨关节炎 

分 类 号：R687.4[医药卫生—骨科学] R446.11[医药卫生—外科学]