CRP/Albumin Has a Promising Prospect as a New Biomarker for the Diagnosis of Periprosthetic Joint Infection.
CRP/Albumin Has a Promising Prospect as a New Biomarker for the Diagnosis of Periprosthetic Joint Infection.
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DOI：
10.2147/idr.s342652
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发表时间：
2021
影响因子：
3.9
通讯作者：
Li T
中科院分区：
文献类型：
--
作者：
Shi W;Wang Y;Zhao X;Yu T;Li T
在本研究中，我们旨在通过比较C反应蛋白（CRP）/白蛋白、全身免疫炎症指数（SII）和现有生物标志物的诊断能力，寻找更有效的生物标志物来诊断假体周围感染（PJI）。在这项单中心回顾性分析中，分析了2013年6月至2021年6月接受膝关节或髋关节翻修术且符合纳入和排除标准的216例患者，其中PJI组80例，非PJI组136例。收集入院第二天的CRP、纤维蛋白原、红细胞沉降率（ESR）、D-二聚体、血小板计数（PC）、中性粒细胞计数（N）、淋巴细胞计数（Lym）、白蛋白计数等信息进行分析。采用受试者工作特征（ROC）曲线比较各种生物标志物的诊断能力，并在PJI组中进行进一步的亚组分析。与非PJI组相比，PJI组CRP、纤维蛋白原、D-二聚体、ESR、CRP/白蛋白和SII均显着升高（P < 0.001），其曲线下面积（AUC）分别为0.937、0.878、0.777、0.914、0.941和0.765。在三个亚组分析中，基于 PJI 培养结果、感染时间和感染部位的吸引力生物标志物没有显着差异（P > 0.05）。 CRP/白蛋白作为诊断PJI的新生物标志物具有广阔的前景，但在PJI亚组分析中预测能力不足。然而，SII 诊断 PJI 的能力不足。因此，SII不适合用作诊断生物标志物。
In the present study, we aimed to identify more effective biomarkers for the diagnosis of periprosthetic joint infection (PJI) by comparing the diagnostic ability of C-reactive protein (CRP)/albumin, systemic immune-inflammation index (SII), and existing biomarkers. In this single-center retrospective analysis, 216 patients who underwent revision knee or hip arthroplasty from June 2013 to June 2021 and met the inclusion and exclusion criteria were analyzed, including 80 patients in the PJI group and 136 patients in the non-PJI group. The following information was collected for analysis, including CRP, fibrinogen, erythrocyte sedimentation rate (ESR), D-dimer, platelet count (PC), neutrophil count (N), lymphocyte count (Lym), and albumin count on the second day of admission. The receiver operating characteristic (ROC) curve was used to compare the diagnostic ability of various biomarkers, and further subgroup analysis was carried out in the PJI group. Compared with the non-PJI group, CRP, fibrinogen, D-dimer, ESR, CRP/albumin, and SII in the PJI group were significantly increased (P < 0.001), and their area under the curve (AUC) was 0.937, 0.878, 0.777, 0.914, 0.941, and 0.765, respectively. In the three subgroup analyses, there was no significant difference in appeal biomarker (P > 0.05) based on PJI culture results, infection time, and infection site. CRP/albumin had a promising prospect as a new biomarker for the diagnosis of PJI, while it had insufficient predictive ability in the PJI subgroup analysis. However, SII had insufficient ability to diagnose PJI. Therefore, SII was not suitable to be used as a diagnostic biomarker.