The serum level of D-Dimer is not suitable for distinguishing between prosthetic joint infection and aseptic loosening
The serum level of D-Dimer is not suitable for distinguishing between prosthetic joint infection and aseptic loosening
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DOI：
10.1186/s13018-019-1461-x
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发表时间：
2019-11-29
影响因子：
2.6
通讯作者：
Jin, Yi
中科院分区：
文献类型：
--
作者：
Huang, Jincheng;Zhang, Yongchao;Jin, Yi
背景探讨血清CRP、ESR、d -二聚体在假体关节感染诊断中的意义。方法回顾性分析2016年6月至2018年12月在我科收治的101例骨关节炎、PJI、无菌性松动患者，根据手术类型分为3组：a组，44例行一期关节置换术；B组，31例PJI患者行关节切除术和垫片植入手术；C组26例无菌性松动患者行翻修关节置换术。比较三组患者的性别、年龄、术前血清CRP、ESR、d -二聚体水平等数据。结果三组患者性别、年龄等一般资料比较，差异均无统计学意义。B组血清CRP水平（43.49 +/- 10.00 mg/L）明显高于A组（2.97 +/- 0.75 mg/L）和C组（4.80 +/- 1.26 mg/L）。B组血清ESR水平（49.84 +/- 5.48 mu g/L）显著高于A组（15.28 +/- 2.63 mu g/L）和C组（22.50 +/- 3.47 mu g/L）。B组血清d -二聚体水平（1.58 +/- 0.17 μ g/L）显著高于A组（0.51 +/- 0.50 μ g/L），与C组（1.22 +/- 0.29 μ g/L）相近。以d -二聚体> 0.85 μ g/L为PJI诊断的最佳阈值，三组患者CRP、ESR、d -二聚体诊断PJI的敏感性和特异性比较，差异均无统计学意义。结论d -二聚体不能作为区分无菌性松动与PJI的指标。
Background To evaluate the meaning of serum CRP, ESR, and D-Dimer in the diagnosis of prosthetic joint infection. Methods In a retrospective study, 101 patients presented with osteoarthritis, PJI, and aseptic loosening were divided into three groups according to the type of operation they received in our department from June 2016 to December 2018: group A, 44 patients treated with primary arthroplasty; group B, 31 PJI patients treated with resection arthroplasty and spacer insertion surgery; group C, 26 aseptic loosening patients treated with revision arthroplasty. Data such as gender, age, preoperative serum CRP, ESR, and D-Dimer level were compared among the three different groups. Results There are no statistically significant differences when comparing general data such as gender and age in patients from the three different groups. However, Serum CRP level in group B (43.49 +/- 10.00 mg/L) is significantly higher than in group A (2.97 +/- 0.75 mg/L) and C (4.80 +/- 1.26 mg/L). Serum ESR level in group B (49.84 +/- 5.48 mu g/L) is significantly higher than those in group A (15.28 +/- 2.63 mu g/L) and C (22.50 +/- 3.47 mu g/L). Serum D-Dimer level in group B (1.58 +/- 0.17 mu g/L) is significantly higher than that in group A (0.51 +/- 0.50 mu g/L), but similar with group C (1.22 +/- 0.29 mu g/L). There are no statistically significant differences when compared with sensitivity and specificity of CRP, ESR, and D-Dimer in the diagnosis of PJI among patients from the three different groups when D-Dimer > 0.85 mu g/L was set as the optimal threshold value for the diagnosis of PJI. Conclusion D-Dimer is not a parameter to distinguish between aseptic loosening and PJI.