外周血sTREM-1、SDF-1、miR-223对膝骨关节炎假体置换术后假体周围感染的预测价值  

Values of peripheral blood sTREM-1,SDF-1 and miR-223 in prediction of postoperative periprosthetic joint infection in knee osteoarthritis patients undergoing prosthetic replacement

作　　者：马志强[1] 董竹林[1] 艾登超 只升鹏 范若焱 杨永超[1] MA Zhi-qiang;DONG Zhu-lin;AI Deng-chao;ZHI Sheng-peng;FAN Ruo-yan;YANG Yong-chao(Tianjin Teda Hospital,Tianjin 300480,China)

机构地区：[1]天津市泰达医院骨一科,天津300480

出　　处：《中华医院感染学杂志》2024年第13期2017-2021,共5页Chinese Journal of Nosocomiology

基　　金：天津市卫生健康科技基金资助项目(ZC20215)。

摘　　要：目的分析膝骨关节炎假体置换术后假体周围感染(PJI)患者外周血可溶性髓系细胞触发受体-1(sTREM-1)、基质细胞衍生因子-1(SDF-1)、miR-223水平变化及对PJI的预测价值。方法选取2020年3月-2023年3月天津泰达医院收治的60例膝骨关节炎假体置换术后PJI患者为研究组,随机选取同期60例膝骨关节炎假体置换术后无合并PJI患者为对照组。比较两组基本资料、外周血sTREM-1、SDF-1、miR-223水平,分析PJI的危险因素,采用受试者工作特征(ROC)曲线分析sTREM-1、SDF-1、miR-223对膝骨关节炎假体置换术后PJI的预测价值。结果研究组手术时间较对照组长,合并糖尿病占比较对照组高(P<0.05);术后1d、3d研究组sTREM-1、SDF-1、miR-223水平高于对照组,研究组术后1d上述指标高于术前,术后3d高于术后1d(P<0.05);Logistic分析显示,手术时间、合并糖尿病、sTREM-1、SDF-1、miR-223是膝骨关节炎假体置换术后PJI的危险因素(P<0.05);ROC分析显示,sTREM-1、SDF-1、miR-223单一及联合预测膝骨关节炎假体置换术后PJI的曲线下面积(AUC)分别为0.874、0.709、0.828和0.931,联合预测优于单一预测(P<0.05)。结论膝骨关节炎假体置换术后PJI患者外周血sTREM-1、SDF-1、miR-223水平升高,三者联合检测对膝骨关节炎假体置换术后PJI具有良好的预测价值。OBJECTIVE To investigate the changes of peripheral blood soluble triggering receptor expressed on my-eloid cells(sTREM-1),stromal-cell-derived factor(SDF-1)and miR-223 in the knee osteoarthritis patients with periprosthetic joint infection(PJI)after prosthetic replacement and analyze the predictive values.METHODS A to-tal of 60 knee osteoarthritis patients who underwent prosthetic replacement had postoperative PJI in Tianjin Teda Hospital from Mar 2020 to Mar 2023 were assigned as the study group,meanwhile,60 knee osteoarthritis pa-tients who underwent prosthetic replacement but did not have postoperative PJI were randomly chosen as the con-trol group.The baseline data and levels of peripheral blood sTREM-1,SDF-1 and miR-223 were compared be-tween the two groups,the risk factors for the PJI were analyzed,and the values of sTREM-1,SDF-1 and miR-223 in prediction of postoperative PJI were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The operation duration of the study group was significantly longer than that of the control group,and the proportion of patients complicated with diabetes mellitus of the study group was significantly higher than that of the control group(P<0.05).The levels of Strem-1,SDF-1 and miR-223 of the study group were significantly higher than those of the control group after the surgery for 1 and 3 days;the levels of the above indexes of the study group were significantly higher after the surgery for 1 day than before the surgery,which were higher after the surgery for 3 days than after the surgery for 1 day(P<0.05).Logistic analysis showed that operation duration,complication with diabetes mellitus,Strem-1,SDF-1 and miR-223 were the risk factors for the postoperative PJI in the knee osteoarthritis patients undergoing prosthetic replacement(P<0.05).ROC curve analysis indicated that the areas under curves(AUCs)of the single detection of sTREM-1,SDF-1,miR-223 and the joint detection were respectively 0.874,0.709,0.828 and 0.931 in prediction of the postoperative PJI i

关 键 词：可溶性髓系细胞触发受体-1 基质细胞衍生因子-1 miR-223 假体周围感染 膝关节置换术 术后感染 

分 类 号：R687.4[医药卫生—骨科学]