[1]全炜琨 胡弦.应激性血糖升高比值对人工关节置换术后感染的预测价值[J].中国中医骨伤科杂志,2022,30(02):69-73.
　QUAN Weikun HU Xuan.Study of Predictive Value of Stress Hyperglycemia Ratio for Infection after Artificial Joint Replacement[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(02):69-73.
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应激性血糖升高比值对人工关节置换术后感染的预测价值()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年02期
页码:
69-73
栏目:
临床报道
出版日期:
2022-02-15

文章信息/Info

Title:
Study of Predictive Value of Stress Hyperglycemia Ratio for Infection after Artificial Joint Replacement
文章编号:
1005-0205(2022)02-0069-05
作者:
全炜琨1 胡弦1
1武汉市蔡甸区人民医院骨科(武汉,430100)
Author(s):
QUAN Weikun1 HU Xuan1
1Department of Orthopeadics, Wuhan Caidian District People’s Hospital, Wuhan 430100,China.
关键词:
感染;  应激性血糖升高比值;  人工关节置换术;  预测价值
Keywords:
infection;  stress hyperglycemia ratio;  artificial joint replacement;  predictive value
分类号:
R687.4
文献标志码:
B
摘要:
目的:探究应激性血糖升高比值(SHR)对人工关节置换术(AJR)后感染的预测价值。方法:选取2014年1月至2020年2月行AJR的998例患者进行研究,对患者随访1年,记录患者感染情况,依据患者感染情况分为感染组(38例)和非感染组(960例)。根据患者术后即刻糖化血红蛋白(HbA1c)、血糖水平计算SHR值。比较非感染组、感染组一般资料,血清乳酸、白蛋白(ALB)水平及SHR; 分析AJR术后感染的患者SHR、HbA1c、血糖水平与血清乳酸、ALB的相关性; 分析SHR、血清乳酸、ALB水平预测AJR术后感染的价值及AJR术后感染的的影响因素。结果:AJR术后感染者38例,感染率为3.81%; 感染组年龄≥70岁、术中出血量≥1 000 mL的患者占比及HbA1c、血糖、SHR、血清乳酸水平高于非感染组,差异有统计学意义(P<0.05); 血清ALB水平低于非感染组,差异有统计学意义(P<0.05); AJR术后感染的患者SHR、HbA1c、血糖水平与血清乳酸水平正相关,差异有统计学意义(P<0.05); 与ALB水平负相关,差异有统计学意义(P<0.05)。SHR、血清乳酸、ALB预测AJR术后感染的曲线下面积(AUC)分别为0.870,0.879和0.687,截断值分别为1.20,2.15 mmol/L及32.87 g/L,敏感度分别为71.1%,76.3%和47.4%,特异性分别为89.0%,89.7%和82.3%,SHR、血清乳酸联合预测AJR术后感染的AUC为0.926,敏感度、特异性分别为92.1%和84.8%。年龄、术中出血量、SHR、HbA1c是影响AJR术后感染的危险因素,差异有统计学意义(P<0.05); ALB是影响AJR术后感染的保护因素,差异有统计学意义(P<0.05)。结论:SHR在AJR术后感染的患者中水平较高,其具有预测行AJR患者术后感染的潜在价值,且其与乳酸联合可更好地预测AJR术后感染。
Abstract:
To explore the predictive value of stress hyperglycemia ratio(SHR)on the infection after artificial joint replacement(AJR). Methods:A total of 998 patients who underwent AJR in hospital from January 2014 to February 2020 were selected for the study. The patients were followed up for 1 year and their infection status was recorded. They were divided into infection group(38 cases)and non-infection group(960 cases)according to the infection status. The SHR value was calculated based on the glycated hemoglobin(HbA1c)and blood glucose level immediately after the operation. The general information of the non-infection group and the infection group were compared, including serum lactic acid, albumin(ALB)levels and SHR,the correlation between SHR, HbA1c, blood glucose and serum lactate and ALB in patients with AJR infection was analyzed; the value of SHR, serum lactic acid and ALB levels in predicting infection after AJR and the influencing factors of infection after AJR were analyzed. Results:A total of 38 cases were infected after AJR, and the infection rate was 3.81%. The proportions with infection of patients who were over 70 years old, intraoperative blood loss more than 1 000 mL, the HbA1c, blood glucose, SHR, and serum lactic acid levels in the infection group were higher than those in the non-infection group(P<0.05), while the serum ALB level was lower than that in the non-infection group(P<0.05); the levels of SHR, HbA1c and blood glucose were positively correlated with the level of serum lactic acid in infection group(P<0.05)and negatively correlated with the level of Alb(P<0.05). The area under the curve(AUC)of SHR, serum lactic acid and ALB for predicting infection after AJR was 0.870, 0.879 and 0.687 respectively; the cut-off value was 1.20, 2.15 mmol/L and 32.87 g/L respectively; the sensitivity was 71.1%, 76.3% and 47.4% respectively; the specificity was 89.0%, 89.7% and 82.3% respectively; the AUC of SHR combined with serum lactic acid predicting infection after AJR was 0.926; the sensitivity and specificity were 92.1% and 84.8% respectively. The age, intraoperative blood loss, SHR, and HbA1c were risk factors affecting infection after AJR(P<0.05). ALB was a protective factor affecting infection after AJR(P<0.05). Conclusion:SHR has a higher level in patients with infection after AJR, which has the potential value of predicting postoperative infection in patients undergoing AJR, and its combination with lactic acid can better predict infection after AJR.

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更新日期/Last Update: 1900-01-01