膝骨性关节炎患者关节积液理化检查与白细胞计数对急性感染诊断的价值  

The Diagnostic Value of Joint Fluid Physicochemical Analysis and白细胞Count in Acute Infection in Patients with Knee Osteoarthritis

作　　者：李庆和 赖巧红 陈玉婷 LI Qinghe;LAI Qiaohong;CHEN Yuting(Longyan Traditional Chinese Medicine Hospital Clinical Laboratory,Longyan 364000,China)

机构地区：[1]龙岩市中医院检验科,福建龙岩364000

出　　处：《中华灾害救援医学》2024年第12期1464-1466,1470,共4页Chinese Journal of Disaster Medicine

摘　　要：目的分析膝骨性关节炎患者关节积液理化检查和白细胞计数,为关节内急性感染诊断和治疗提供依据。方法纳入观察对象218例,均为龙岩市中医院收治的膝关节炎患者,病例资料采集时间范围为2019年1月至2023年6月,对入组患者的临床资料开展回顾性分析研究。根据是否发生关节内急性感染分为感染组(n=95)与非感染组(n=123)。比较两组患者一般资料,关节积液的一般性状检查:量、透明度、黏稠度;化学检查:黏蛋白凝块形成试验,蛋白质、葡萄糖检查;白细胞计数。结果感染组关节积液液量、蛋白质、血清葡萄糖与积液葡萄糖的差值、白细胞计数均高于非感染组,差异均有统计学意义(P<0.05)。感染组关节积液透明度呈浑浊状,非感染组呈清透状。感染组关节积液黏稠度明显低于非感染组(P<0.05)。感染组关节积液黏蛋白凝块形成试验良好率明显低于非感染组(P<0.05)。结论膝骨性关节炎患者关节积液理化检查和白细胞计数联合检测,对其发生关节内急性感染的诊断具有较好价值,可作为临床辅助性诊断和监测指标。Objective To analyze the physico-chemical properties of joint effusion and white blood cell(白细胞)count in patients with knee osteoarthritis,providing a basis for the diagnosis and treatment of intra-articular acute infections.Methods A total of 218 patients with knee osteoarthritis treated at Longyan City Hospital of Traditional Chinese Medicine between January 2019 and June 2023 were included in this retrospective study.The patients were divided into two groups based on whether they developed intra-articular acute infection:the infection group(n=95)and the non-infection group(n=123).General patient demographics,joint effusion characteristics(volume,transparency,viscosity),and chemical tests(mucin clot formation test,protein and glucose levels)were compared.Additionally,leukocyte count was assessed.Results The infection group had significantly higher joint effusion volume,protein levels,serum glucose and the difference between synovial and serum glucose,as well as leukocyte count compared to the non-infection group(P<0.05).The joint effusion in the infection group appeared turbid,whereas the non-infection group had clear effusion.The viscosity of joint effusion in the infection group was significantly lower than in the non-infection group(P<0.05).The mucin clot formation test showed a significantly lower success rate in the infection group compared to the non-infection group(P<0.05).Conclusion Combined testing of joint effusion physico-chemical properties and leukocyte count in patients with knee osteoarthritis provides valuable diagnostic information for detecting intra-articular acute infections.These tests can serve as useful adjuncts for clinical diagnosis and monitoring.

关 键 词：膝骨性关节炎 黏蛋白凝块形成试验 白细胞计数 

分 类 号：R684.3[医药卫生—骨科学]