Natural progress of D-dimer following total joint arthroplasty: a baseline for the diagnosis of the early postoperative infection.
Natural progress of D-dimer following total joint arthroplasty: a baseline for the diagnosis of the early postoperative infection.
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DOI：
10.1186/s13018-018-0730-4
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发表时间：
2018-02-13
影响因子：
2.6
通讯作者：
Koo KH
中科院分区：
文献类型：
--
作者：
Lee YS;Lee YK;Han SB;Nam CH;Parvizi J;Koo KH
早期发现并及时干预对于治疗假体周围感染（PJI）至关重要。 D-二聚体是一种纤维蛋白降解产物，其特点是术后早期变化迅速，半衰期短。本前瞻性研究的目的是结合 ESR 和 CRP 来测量关节置换术后 D-二聚体水平的变化。对 65 名接受选择性初次全髋关节置换术（38 例患者 38 髋）或全膝关节置换术（27 例患者 27 膝）的患者在手术前一天、术后第 1、2、3、5 天以及第 2 和 6 周测量 ESR、CRP 和 D-二聚体水平。我们比较了三种生物标志物的围手术期变化。 ESR 水平从术后第 1 天开始升高，并在术后第 5 天达到峰值 45 mm/h。这种升高持续到术后第 6 周。CRP 水平从术后第 1 天开始升高，并在术后第 2 天和第 3 天之间达到峰值 10 mg/dl。CRP 水平在术后第 2 周左右降至正常水平。D-二聚体水平急剧升高，并在术后第 1 天达到峰值 4.5 μg/dl。术后第2天，它下降到基线水平。此后又缓慢升高，并在术后第2周达到第二个峰值。D-二聚体在术后极早期表现出比ESR和CRP更快的上升和下降。如果与 ESR 和 CRP 水平相结合，D-二聚体检测可能对 PJI 的早期检测有效。我们研究中D-二聚体的术后变化可以作为PJI早期诊断的基线。
Early detection followed by prompt intervention is essential for the treatment of periprosthetic joint infection (PJI). D-dimer, a fibrin degradation product, characteristically changes rapidly during early postoperative period and has a short half-life. The aim of this prospective study was to measure postoperative change of D-dimer level after joint arthroplasty in conjunction with ESR and CRP. ESR, CRP, and D-dimer levels were measured on the day before surgery, postoperative days 1, 2, 3, and 5 and weeks 2 and 6 in 65 patients who underwent elective primary total hip arthroplasty (38 hips in 38 patients) or total knee arthroplasty (27 knees in 27 patients). We compared perioperative changes of the three biomarkers. ESR level was elevated from postoperative day 1 and reached a peak level of 45 mm/h at postoperative day 5. The elevation persisted until postoperative week 6. CRP level was elevated from postoperative day 1 and reached a peak level of 10 mg/dl between postoperative day 2 and day 3. The CRP level was decreased to the normal level around postoperative week 2. D-dimer level was sharply elevated and peaked to 4.5 μg/dl at postoperative day 1. At postoperative day 2, it decreased to baseline level. After then, it slowly elevated again and reached a second peak at postoperative week 2. D-dimer showed a more rapid rise and fall than ESR and CRP in very early postoperative period. The D-dimer test might be effective in early detection of PJI, if combined with levels of ESR and CRP. The postoperative change of D-dimer in our study can serve as a baseline for early diagnosis of PJI.
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影响因子：
3.1
作者：
Chen CJ;Wang CJ;Huang CC
通讯作者：
Huang CC
影响因子：
5.3
作者：
Wyatt, M. C.;Beswick, A. D.;Blom, A. W.
通讯作者：
Blom, A. W.
影响因子：
4.2
作者：
Fehring, Thomas K.;Odum, Susan M.;Gioe, Terence J.
通讯作者：
Gioe, Terence J.
影响因子：
3.1
作者：
Parvizi J;Cavanaugh PK;Diaz-Ledezma C
通讯作者：
Diaz-Ledezma C
影响因子：
3.5
作者：
Kim, Tae Won;Kim, Dong Hwan;Lee, Beom Koo
通讯作者：
Lee, Beom Koo