Exciting Performance of Plasma Fibrinogen in Periprosthetic Joint Infection Diagnosis.
Exciting Performance of Plasma Fibrinogen in Periprosthetic Joint Infection Diagnosis.
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DOI：
10.1111/os.12964
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发表时间：
2021-05
影响因子：
2.1
通讯作者：
Jin Y
中科院分区：
文献类型：
--
作者：
Huang JC;Chen X;Qiang S;Zheng WD;Zheng J;Jin Y
探讨血清C反应蛋白（CRP）、红细胞沉降率（ESR）、血小板计数/平均血小板体积比（PC/MPV）、血浆纤维蛋白原和D-二聚体在诊断假体周围关节感染（PJI）中的意义。我们回顾性分析了2016年7月至2019年12月诊断为原发性骨关节炎的149例患者的临床资料（OA组，平均年龄63.18岁[范围，53-82岁]，18例男性，46例女性），PJI（PJI组，平均年龄63.74岁[范围，52-81岁]，16名男性，31名女性），无菌性松动无菌组，平均年龄63.18岁，男12例，女26例。比较了人口统计学数据以及术前CRP、ESR、PC/MPV、纤维蛋白原和D-二聚体诊断PJI的敏感性和特异性。三组人口学资料比较无显著性差异。CRP表达水平（50.67 ± 58.98 mg/L），血沉（50.55 ± 25.81 mm/h），PC/MPV（35.79 ± 18.00），纤维蛋白原（4.85 ± 1.33）μg/mL，PJI组高于OA组（CRP：4.09 ± 9.68 mg/L; ESR：13.44 ± 9.32 mm/1 h; PC/MPV：24.97 ± 7.58; Fg：3.09 ± 0.55 μg/mL）和无菌组CRP：7.01 ± 11.83 mg/L; ESR：22.47 ± 17.53 mm/1 h; PC/MPV：25.18 ± 11.48; PJI组血浆D-二聚体表达水平（1.60 ± 1.29 mg/L）高于OA组（0.49 ± 0.42 mg/L），但与无菌组（1.21 ± 1.35 mg/L）相似。受试者工作特征（ROC）曲线分析表明，CRP、ESR、PC/MPV、纤维蛋白原和D-二聚体的ROC曲线下面积（AUC）为0.892（95%置信区间，0.829-0.954）、0.888（0.829-0.947）、0.686（0.589-0.784）、0.873（0.803-0.943）和0.835（0.772-0.899）。以PC/MPV > 31.70、Fg>4.01 μg/mL、D‐dimer >1.17 mg/L作为诊断PJI的阈值时，PC/MPV诊断PJI的敏感性低于ESR和血浆Fg。相比之下，当比较CRP、ESR、PC/MPV、纤维蛋白原和D-二聚体在PJI诊断中的特异性时，没有显著差异。血浆纤维蛋白原是PJI较好的新的辅助诊断指标。血小板计数和平均血小板体积比以及血浆D-二聚体不应作为PJI诊断的首筛标志物，而血浆纤维蛋白原可作为PJI诊断的辅助标志物。
To test the significance of serum C‐reactive protein (CRP), the erythrocyte sedimentation rate (ESR), the platelet count/mean platelet volume ratio (PC/MPV), plasma fibrinogen, and D‐Dimer in periprosthetic joint infection (PJI) diagnosis. We retrospectively analyzed the clinical data of 149 patients diagnosed from July 2016 to December 2019 with primary osteoarthritis (OA group, average age 63.18 years [range, 53–82 years] 18 males, 46 females), PJI (PJI group, average age 63.74 years [range, 52–81 years], 16 males, 31 females), and aseptic loosening (aseptic group, average age 63.18 years [range, 53–80 years], 12 male, 26 female) in our department. Demographic data and the sensitivity and specificity of preoperative CRP, ESR, PC/MPV, fibrinogen, and D‐Dimer in PJI diagnosis were compared. There were no significant differences when the demographic data of the three groups were compared. The expression level of CRP (50.67 ± 58.98 mg/L), ESR (50.55 ± 25.81 mm/h), PC/MPV (35.79 ± 18.00), and fibrinogen (4.85 ± 1.33 μg/mL) in the PJI group were higher than in the OA group (CRP: 4.09 ± 9.68 mg/L; ESR:13.44 ± 9.32 mm/1 h; PC/MPV: 24.97 ± 7.58; fibrinogen: 3.09 ± 0.55 μg/mL) and the aseptic group (CRP: 7.01 ± 11.83 mg/L; ESR: 22.47 ± 17.53 mm/1 h; PC/MPV: 25.18 ± 11.48; fibrinogen: 3.39 ± 0.80 μg/mL), respectively. The expression level of plasma D‐dimer (1.60 ± 1.29 mg/L) in the PJI group was higher than in the OA group (0.49 ± 0.42 mg/L) but similar to that in the aseptic group (1.21 ± 1.35 mg/L). Receiver operating characteristic (ROC) curve analysis demonstrated that the areas under the ROC curve (AUC) for CRP, ESR, PC/MPV, fibrinogen, and D‐dimer were 0.892 (95% confidence interval, 0.829–0.954), 0.888 (0.829–0.947), 0.686 (0.589–0.784), 0.873 (0.803–0.943), and 0.835 (0.772–0.899), respectively. When PC/MPV > 31.70, fibrinogen >4.01 μg/mL, and D‐dimer >1.17 mg/L were set as the threshold values for the diagnosis of PJI, the sensitivity of PC/MPV in PJI diagnosis was lower than that of ESR and plasma fibrinogen. In contrast, there was no significant difference when comparing the specificity of CRP, ESR, PC/MPV, fibrinogen, and D‐dimer in PJI diagnosis. Plasma fibrinogen is a good new auxiliary diagnostic marker for PJI. Platelet count and mean platelet volume ratio and plasma D‐dimer should not be used as the first screen markers for PJI diagnosis, whereas plasma fibrinogen can be used as an auxiliary marker for PJI diagnosis.
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影响因子：
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影响因子：
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