人工关节置换后假体感染的相关血液炎性标志物诊断方法

目的：探究与分析血液炎性标志物IL-6在人工关节置换后假体感染的临床诊断应用。方法：选取本院自2012年2月-2014年2月收治的120例人工关节置换患者作为临床研究对象。全部患者进行血清采集并送检,观察患者术前及术后1、2、3、5、21 d的血清IL-6变化情况,明确发生感染的患者例数;同时对其中80例患者的血清IL-6含量与穿刺液细菌培养结果进行对比。结果：两组术后1、2 d的血清IL-6水平较均明显升高（2 d〉1 d〉术前）,术后3、5 d呈下降趋势（5 d〈3 d〈2 d）,差异均有统计学意义（P〈0.05）;无感染组术后21 d血清IL-6水平较术后5 d明显下降,感染组则明显升高,差异均有统计学意义（P〈0.05）。无感染发生组血清IL-6于术后3 d达最高水平,并于术后5 d恢复至正常水平;感染组血清IL-6术后5 d无法恢复至正常水平。80例患者中,血清IL-6灵敏度为86.67%,特异度为88.00%,假阳性率为12.00%,假阴性率为13.33%。结论：IL-6在诊断人工关节置换术后假体感染时具有较高的灵敏度、特异度及准确度,可作为人工关节置换术后假体周围感染早期诊断中一项可靠的辅助标记物。

The Blood Inflammatory Markers Diagnostic Methods after the Artificial Joint Replacement Prosthesis Infection

Objective： To explore and analyze blood inflammatory markers IL-6 prosthesis infection clinical diagnostic applications in artificial joint replacement. Method： 120 cases who were treated by artificial joint replacement were selected in our hospital from February 2012 to February 2014. All patients in the early morning gathering of serum submission, the changes of patients＇ serum IL-6 were observed before and after surgery 1, 2, 3, 5, 21d, while the number of patients who were occurred the infection were cleared out. At the same time, the serum IL- 6 levels were compared with puncture fluid bacterial culture in 80 cases. Result： Postoperative 1, 2 d, the serum level of IL- 6 were significantly elevated（2 d〉 d〉 1） of two groups, postoperative 3, 5 d were downtrend（5 d 〈3 d〈 2 d）, the differences had statistical significance（P〈0.05）; postoperative 21 d, the serum levels of IL-6 was decreased obviously than postoperative 5 d of the no infections occurred group, the infections group was obviously higher, the differences had statistical significance（P〈0.05）. The no infections occurred group with serum IL-6 after 3 d reached the highest level, and in returned to normal levels after 5 d, the infections group with serum IL-6 postoperative 5 d not recovered to normal levels. The sensitivity was 86.67%, specificity was 88.00%, false positive rate was 12.00%, false negative rate was 13.33% of the serum IL-6 levels in the 80 cases. Conclusion： IL-6 in the diagnosis of prosthetic hip replacement surgery has a high sensitivity, specificity and accuracy of infection, can be used as artificial joint replacement prosthesis after infection around the early diagnosis of a reliable marker assisted matter.