全膝关节置换术后金黄色葡萄球菌感染与类风湿关节炎的炎症标志物比较  

Screening of markers of infection after total knee replacement

作　　者：马骏[1] 刘子坤 尚玉芝 杨德盛[3] 刘毅[1] MA Jun;LIU Zikun;SHANG Yuzhi;YANG Desheng;LIU Yi(Department of Pediatric Orthopaedics,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Operating Room,Third Division General Hospital,Xinjiang Production and Construction Corps,Tumushuke,Xinjiang Uygur Autonomous Region 843900,China;Department of Orthopaedics,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院小儿骨科,乌鲁木齐830000 [2]新疆生产建设兵团第三师总医院手术室,新疆维吾尔自治区图木舒克843900 [3]新疆医科大学第一附属医院骨科,乌鲁木齐830000

出　　处：《中华骨与关节外科杂志》2024年第10期931-938,共8页Chinese Journal of Bone and Joint Surgery

基　　金：新疆维吾尔自治区自然科学基金(2016D01C289)。

摘　　要：目的:比较全膝关节置换术(TKA)后金黄色葡萄球菌感染与类风湿关节炎(RA)的炎症标志物。方法:选用新西兰大白兔30只,采用随机数字表法分为TKA组、RA组及对照组,每组各10只。术前及术后第1、3、5日,于患膝髌骨上、下缘2 cm处测量周径,并计算差值,以量化膝关节肿胀程度,记录膝关节肿胀变化情况。血清中C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)均采用酶联免疫吸附试验(ELISA)进行检测;红细胞沉降率(ESR)通过全自动血沉仪检测分析。结果:对照组实验兔髌骨上、下缘2 cm处周径,在造模前24 h、造模后24 h、接种后24 h、接种后48 h进行整体比较,差异均无统计学意义(P均>0.05);TKA组与RA组实验兔髌骨上、下缘2 cm处周径,在造模前24 h、造模后24 h、接种后24 h、接种后48 h进行整体比较,差异均有统计学意义(P均<0.05)。造模前24 h,3组实验兔髌骨上、下缘2 cm处周径比较,差异均无统计学意义(P均>0.05);造模后24 h、接种后24 h、接种后48 h,3组实验兔髌骨上、下缘2 cm处周径比较,差异均有统计学意义(P均<0.05)。对照组实验兔的CRP、ESR、sVCAM-1、sICAM-1、IL-1β、IL-6、IL-17、PCT水平,在造模前24 h、造模后24 h、接种后24 h、接种后48 h进行整体比较,差异均无统计学意义(P均>0.05)。TKA组实验兔的CRP、ESR、sVCAM-1、sICAM-1、IL-1β、IL-6、IL-17、PCT水平,在造模前24 h、造模后24 h、接种后24 h、接种后48 h进行整体比较,差异均有统计学意义(P均<0.05)。RA组实验兔的CRP水平,在造模前24 h、造模后24 h、接种后24 h、接种后48 h进行整体比较,差异均无统计学意义(P均>0.05);ESR、sVCAM-1、sICAM-1、IL-1β、IL-6、IL-17、PCT水平,在造模前24 h、造模后24 h、接种后24 h、接种后48 h进行整体比较,差异均有�Objective:To compare the inflammatory markers of Staphylococcus aureus infection after total knee arthroplasty(TKA)with those of rheumatoid arthritis(RA).Methods:Thirty New Zealand white rabbits were randomly divided into TKA group,RA group,and control group using a random number table.The circumference at 2 cm above and below the patella of the affected knee was measured before surgery and on days 1,3,and 5 post-surgery to quantify the degree of knee joint swelling and record changes in knee joint swelling.Serum levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-17(IL-17),soluble intercellular adhesion molecule-1(sICAM-1),and soluble vascular cell adhesion molecule-1(sVCAM-1)were detected using enzyme-linked immunosorbent assay(ELISA);erythrocyte sedimentation rate(ESR)was analyzed using an automatic erythrocyte sedimentation rate analyzer.Results:There were no statistically significant differences in the circumference at 2 cm above and below the patella of the control group rabbits at 24 hours before modeling,24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation(all P>0.05);however,there were statistically significant differences in the TKA and RA groups at the same time points(all P<0.05).Before modeling,there were no statistically significant differences in the circumference at 2 cm above and below the patella among the three groups of rabbits(all P>0.05);however,at 24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation,there were statistically significant differences(all P<0.05).The levels of CRP,ESR,sVCAM-1,sICAM-1,IL-1β,IL-6,IL-17,and PCT in the control group rabbits showed no statistically significant differences at 24 hours before modeling,24 hours after modeling,24 hours after inoculation,and 48 hours after inoculation(all P>0.05).The levels of CRP,ESR,sVCAM-1,sICAM-1,IL-1β,IL-6,IL-17,and PCT in the TKA group rabbits showed statistically significant differences at all time points(all P<0.05

关 键 词：全膝关节置换术 术后感染 炎症标志物 

分 类 号：R687.4[医药卫生—骨科学]