膝关节假体周围感染MRI影像表现及其与血清α-防御素、白细胞介素-6、D-二聚体水平相关性研究  

MRI Findings of Periprosthetic Joint Infection in Knee Joint and Their Correlation with Serumα-Defentin,Interleukin-6 and D-dimer Levels

作　　者：杨杰 刘涛 赵志光 杨东海 YANG Jie;LIU Tao;ZHAO Zhi-guang;YANG Dong-hai(Department of Imaging,Fengfeng General Hospital of North China Medical and Health Group,Handan 056000,Hebei Province,China;Department of Orthopaedics,Fengfeng General Hospital of North China Medical and Health Group,Handan 056000,Hebei Province,China)

机构地区：[1]华北医疗健康集团峰峰总医院影像科,河北邯郸056000 [2]华北医疗健康集团峰峰总医院骨科,河北邯郸056000

出　　处：《中国CT和MRI杂志》2025年第1期168-170,共3页Chinese Journal of CT and MRI

基　　金：国家卫生健康委医药卫生科技发展研究中心课题(W2022ZT569)。

摘　　要：目的 探讨膝关节假体周围感染(PJI)的MRI影像表现及其与血清α-防御素、白细胞介素-6、D-二聚体水平相关性。方法 选择2017年2月至2021年10月于本院行全膝关节置换术后的150例患者的临床资料,术后行MRI检查和血清α-防御素、白细胞介素-6、D-二聚体水平检测。根据是否发生PJI将患者分为感染组(42例)和非感染组(108例)。比较两组患者的MRI表现和血清α-防御素、白细胞介素-6、D-二聚体水平差异,采用Spearman相关系数分析PJI的MRI表现与血清α-防御素、白细胞介素-6、D-二聚体水平的相关性。结果 感染组患者假体周围发生骨膜反应、存在假体关节囊积液以及假体周围肌内水肿所占比例显著高于非感染组(P<0.05),而感染组与非感染组之间假体周围骨质溶解和骨髓水肿所占比例差异均无统计学意义(P>0.05)。感染组患者血清α-防御素显著低于非感染组(P<0.05),而白细胞介素-6、D-二聚体水平显著高于非感染者(P<0.05)。Spearman相关系数分析显示,感染组患者MRI表现骨膜反应、假体关节囊积液、肌内水肿均与血清α-防御素水平呈负相关(P<0.05),而与血清白细胞介素-6、D-二聚体水平均呈正相关(P<0.05)。结论膝关节PJI的MRI影像表现具有一定特征性,其与血清α-防御素、白细胞介素-6、D-二聚体水平具有一定相关性,有助于为临床的定性诊断以及治疗决策提供更科学的影像学证据。Objective To investigate the MRI findings of periprosthetic joint infection(PJI)in knee joint and its correlation with serumα-defensin,interleukin-6 and D-dimer levels.Methods Clinical data of 150 patients who underwent total knee arthroplasty in our hospital from February 2017 to October 2021 were selected.MRI examination and serumα-defansin,interleukin-6 and D-dimer levels were performed after surgery.According to the occurrence of PJI,the patients were divided into infected group(42 cases)and non-infected group(108 cases).The differences in MRI findings and serumα-defansin,interleukin-6 and D-dimer levels between the two groups were compared,and the correlation between PJI MRI findings and serumα-defansin,interleukin-6 and D-dimer levels was analyzed by Spearman correlation coefficient.Results The proportion of periprosthesis periosteal reaction,capsular effusion and periprosthesis intramuscular edema in infected group was significantly higher than that in non-infected group(P<0.05),while there was no statistical significance in the proportion of periprosthesis osteolysis and bone marrow edema between infected group and noninfected group(P>0.05).Serumα-defencin in infected group was significantly lower than that in noninfected group(P<0.05),while the levels of interleukin-6 and D-dimer were significantly higher than those in non-infected group(P<0.05).Spearman correlation coefficient analysis showed that the MRI findings of periosteal reaction,prosthesis capsular effusion and intramuscular edema were negatively correlated with serumα-defencin levels(P<0.05),but positively correlated with serum interleukin-6 and D-dimer levels(P<0.05).Conclusion The MRI findings of PJI in knee joint have certain characteristics,which are correlated with the levels of serumα-defencin,interleukin-6 and D-dimer,which is helpful to provide more scientific imaging evidence for clinical qualitative diagnosis and treatment decision.

关 键 词：假体周围感染 MRI Α-防御素 白细胞介素-6 D-二聚体 相关性 

分 类 号：R816.8[医药卫生—放射医学] R687.4[医药卫生—临床医学]