文章摘要
黄金承,王振,赵永强,强硕,金毅,郑稼.血清 D-二聚体在关节假体周围感染诊断中的意义[J].,2019,27(17):1566-1569
血清 D-二聚体在关节假体周围感染诊断中的意义
Significance of serum D- dimer in the diagnosis of prosthetic joint infection
Received:March 30, 2019  
DOI:
中文关键词: 关节假体周围感染, C 反应蛋白, 血沉, D-二聚体, 诊断
英文关键词: prosthetic joint infection (PJI) , C-reactive protein (CRP) , erythrocyte sedimentation rate (ESR) , D-di⁃ mer, diagnosis
基金项目:
Author NameAffiliation
HUANG Jin- cheng  
WANG Zhen  
ZHAO Yong-qiang  
QIANG Shuo  
JIN Yi  
ZHENG Jia  
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中文摘要:
      摘要:[目的] 探讨血清 D-二聚体在关节假体周围感染 (prosthetic joint infection, PJI) 诊断中的意义。[方法] 回顾性分析本科 2016 年 6 月~2018 年 6 月收治的 80 例患者,其中初次置换组 33 例,PJI 分期翻修 24 例,无菌松动 翻修术组 23 例。比较三组患者术前血清 C-反应蛋白(CRP)、血沉(ESR)、D-二聚体等数据。[结果]三组患者一 般资料比较差异无统计学意义 (P>0.05)。PJI 患者血清 CRP、ESR 水平显著高于初次关节置换及无菌性松动患者 (P<0.05),PJI 患者血清 D-二聚体水平显著高于初次置换者 (P<0.05),但与无菌性松动患者体内 D-二聚体水平差 异不具有统计学意义 (P>0.05)。当以 D-二聚体>0.85 μg/L 为 PJI 诊断标准时,血清 CRP、ESR、D-二聚体诊断 PJI 的敏感性、特异性类似,差异无统计学意义(P>0.05)。当以 D-二聚体>0.5 μg/L 为 PJI 诊断标准时,D-二聚体诊断 PJI 的敏感性与 CRP 及 ESR 类似 (P>0.05),但特异性差于 CRP 及 ESR,差异具有统计学意义 (P<0.05)。[结论] 与 CRP、ESR 相比,血清 D-二聚体在 PJI 诊断中无明显优势。
英文摘要:
      Abstract: [Objective] To explore the significance of serum D-Dimer in the diagnosis of prosthetic joint infection (PJI) . [Methods] A retrospective study was conducted on 80 patients, including 33 patients who underwent primary total knee arthro? plasty (TKA) for osteoarthritis, 24 patients who received first stage of revision for PJI, and 23 patients who had definitive revi? sion surgery for aseptic prosthetic loosening. The serum levels of C- reactive protein (CRP) , erythrocyte sedimentation rate (ESR) and D-dimer before operation were compared among the three groups. [Results] There were no statistically significant difference among the three groups in general data, such as gender and age (P>0.05) . The serum levels of CRP and ESR in the PJI group proved significantly higher than the primary TKA group and the loosening group (P<0.05) . Although serum D-Dimer level in the PJI group was proved significantly higher than the primary TKA group (P<0.05) , it was not significantly different be? tween the PJI group and the loosening (P>0.05) . As the diagnosis criteria set at D-dimer>0.85 μg/L, the sensitivity and speci? ficity for diagnosis of PJI were not significantly different among CRP, ESR and D-dime. By contrast, as the diagnosis criteria set at D-dimer >0.05 μg/L, the sensitivity for diagnosis of PJI were not significantly different among CRP, ESR and D-dime (P> 0.05) , while the specificity of the D- dimer for diagnosis of PJI proved significantly inferior to the CPR and ESR (P<0.05) . [Conclusion] The serum D-dimer does not take any advantage over the CRP and ESR for diagnosis of PJI.
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