摘要
目的分析血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、热休克蛋白70(HSP70)、降钙素原(PCT)水平对脊柱手术切口深部感染的预测价值。方法选取2018年5月至2020年12月在该院接受脊柱手术治疗的395例患者,根据术后切口深部感染发生情况将患者分为感染组、未感染组。两组均应用免疫比浊法检测血清SAA水平,酶联免疫吸附实验检测血清CRP、HSP70水平,电化学发光法检测血清PCT水平;分析患者术后切口深部感染发生情况,比较感染组、未感染组术后24 h血清SAA、CRP、HSP70、PCT水平,并采用受试者工作特征(ROC)曲线分析血清SAA、CRP、HSP70、PCT水平单项及联合检测对脊柱手术切口深部感染的预测价值。结果接受脊柱手术治疗的395例患者术后切口感染发生率为5.82%,细菌培养共分离出45株病原菌(革兰阳性菌12株、革兰阴性菌31株、真菌2株);感染组与未感染组相比,术后24 h血清SAA、CRP、HSP70、PCT水平均较高(P<0.05),两组间其余资料比较差异无统计学意义(P>0.05);血清SAA、CRP、HSP70、PCT水平联合预测感染组切口深部感染的灵敏度、特异度、曲线下面积分别为100.00%、91.38%、0.992,灵敏度和AUC均高于单独预测(α<0.02),特异度与单独预测差异无统计学意义(P>0.05)。结论脊柱手术术后发生切口深部感染患者感染发生率为5.82%,病原菌主要为革兰阳性菌、革兰阴性菌和真菌,感染组的术后24 h血清SAA、CRP、HSP70、PCT水平均较未发生切口深部感染患者高,血清SAA、CRP、HSP70、PCT水平均对患者术后切口深部感染具有一定的预测作用,但以四者联合检测时的预测效能更佳。
Objective To analyze analyze the predictive value of serum levels of amyloid A(SAA),C-reactive protein(CRP),heat shock protein 70(HSP70)and procalcitonin(PCT)for deep wound infection in spinal surgery.Methods 395 patients with spinal surgery in our hospital from May 2018 to December 2020 were selected.According to the incidence of postoperative deep wound infection,the patients in the study group were divided into infection group and non infection group.The levels of serum SAA,CRP,HSP70 and PCT were detected by immunoturbidimetric assay,enzyme-linked immunosorbent assay and electrochemiluminescence assay in the two groups.The incidence of postoperative deep wound infection was compared between the infected group and the uninfected group,the serum SAA,CRP,HSP70,PCT levels of 24 h after operation in infected group and uninfected group were compared,and the receiver operating characteristic(ROC)curve of the subjects was used to analyze the predictive value of single and combined detection of serum SAA,CRP,HSP70 and PCT detection on deep wound infection in spinal surgery.Results The infection rate of postoperative incision infection in 395 patients undergoing spinal surgery was 5.82%,and a total of 45 pathogenic bacteria were isolated from bacterial culture(12 Gram positive bacteria,31 Gram negative bacteria,and 2 fungi).Compared with the non infected group,the levels of serum SAA,CRP,HSP70,and PCT were higher in the infected group 24 hours after surgery(P<0.05),while there was no statistically significant difference in other data between the two groups(P>0.05).The sensitivity,specificity and area under the curve of serum SAA,CRP,HSP70 and PCT levels in the combined prediction group were 100.00%,91.38% and 0.992,respectively.The sensitivity and AUC were higher than those in the single prediction group(α<0.02).There was no significant difference between the specificity and the single prediction group(P>0.05).Conclusion The incidence of infection in patients with deep wound infection after spinal surgery is 5.82%,and the main pathogens are Gram-positive bacteria,Gram-negative bacteria and fungi,The levels of serum SAA,CRP,HSP70 and PCT in patients with deep wound infection after spinal surgery are higher than those in patients without deep wound infection.The levels of serum SAA,CRP,HSP70 and PCT have certain predictive effect on patients with Deep wound infection after spinal surgery,but the combined detection of the four has better predictive effect.
作者
赵腾
李家江
刘祥清
ZHAO Teng;LI Jia-jiang;LIU Xiang-qing(Zaozhuang Hospital,Zaozhuang Mining Group,1.Orthopedics;Spine Surgery,Zaozhuang,Shandong 277100,China)
出处
《颈腰痛杂志》
2024年第6期1020-1024,共5页
The Journal of Cervicodynia and Lumbodynia
关键词
血清淀粉样蛋白A
C反应蛋白
热休克蛋白70
降钙素原
切口深部感染
病原菌
受试者工作特征曲线
预测效能
serum amyloid A
C-reactive protein
heat shock protein 70
procalcitonin
deep wound infection
pathogenic bacteria
receiver operating characteristic curve
predictive efficiency
