人工髋关节置换术前后红细胞沉降率、C反应蛋白及血清淀粉样蛋白变化的检验分析

目的分析人工髋关节置换术前后红细胞沉降率(ESR)、C反应蛋白(CRP)和血清淀粉样蛋白A(SAA)的变化。方法选取该院2012年4月至2015年4月收治的单侧人工髋关节置换术共124例作为受试对象,患者接受人工髋关节置换术,检测患者术前和术后1、3、5、7、14d和1、3个月的CRP、ESR和SAA水平。并回溯性分析术后出现下肢深静脉血栓阻塞的患者与术后恢复正常的患者在上述指标的区别。结果 CRP术后急剧上升,并于第3天到达峰值后迅速消退,术后1个月即恢复至术前水平;ESR术后持续上升直至到达峰值后缓慢下降,术后3个月可恢复至正常水平;SAA术后急剧上升,于3d内到达峰值并缓慢下降,术后3个月可恢复至术前水平。出现术后并发症的患者,其CRP、ESR和SAA水平在同一时间显著高于术后正常恢复的患者,且术后3个月不能恢复至术前水平。结论行人工髋关节置换术后动态监测患者CRP、ESR和SAA水平可能有助于提早发现术后下肢深静脉血栓堵塞并发症。

Analysis on tests of ESR,CRP and serum amyloid changes before and after total hip arthroplasty

Objective To analyze the changes of erythrocyte sedimentation rate (ESR) ,C‐reactive protein (CRP) and serum am‐yloid A (SAA) before and after total hip arthroplasty(THA) .Methods A total of 124 cases of unilateral THA in our hospital from April 2012 to April 2015 were selected as the research subjects .The CRP ,ESR and SAA levels were detected before operation and on postoperative 1 ,3 ,5 ,7 ,14 d ,and 1 ,3 months .The differences of above indexes between the patients with postoperative deep venous thrombosis (DVT ) obstruction and the patients with normal recovery were retrospectively analyzed .Results CRP was sharply increased after operation and reached the peak value on 3 d ,then rapidly faded away ,and recovered to the preoperative level at postoperative 1 month;ESR was continuously elevated until reaching the peak value ,then slowly declined ,and recovered to the normal level at postoperative 3 months;SAA was sharply elevated after operation ,reached the peak value on 3 d ,then slowly de‐clined and could recovered to the normal level at postoperative 3 months .The CRP ,ESR and SAA levels in the patients with post‐operative complications occurrence were significantly higher than those in the patients with postoperative normal recover at the same time ,moreover which could not recover to the preoperative levels .Conclusion Dynamically monitoring CRP ,ERS and SAA after THA could conduce to early discover postoperative lower limbs DVT blockage complication .