[1]万 楠,王 璐,孟冬娅,等.炎症标志物在感染性和痛风性关节炎中鉴别诊断的应用价值[J].现代检验医学杂志,2015,30(03):142-144.[doi:10.3969/j.issn.1671-7414.2015.03.043]
　WAN Nan,WANG Lu,MENG Dong-ya,et al.Evaluation of Several Inflammatory Markers to Infectious and Gouty Arthritis[J].Journal of Modern Laboratory Medicine,2015,30(03):142-144.[doi:10.3969/j.issn.1671-7414.2015.03.043]
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炎症标志物在感染性和痛风性关节炎中鉴别诊断的应用价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年03期
页码:
142-144
栏目:
检验与临床
出版日期:
2015-06-10

文章信息/Info

Title:
Evaluation of Several Inflammatory Markers to Infectious and Gouty Arthritis
文章编号:
1671-7414(2015)03-142-03
作者:
万 楠; 王 璐; 孟冬娅; 郑 伟; 胡晓芳
沈阳军区总医院检验科,沈阳 110016
Author(s):
WAN Nan; WANG Lu; MENG Dong-ya; ZHENG Wei; HU Xiao-fang
Department of Clinical Laboratory,Shenyang General Hospital of Shenyang Military Command of PLA,Shenyang 110016,China
关键词:
炎症标志物;  感染性关节炎;  痛风性关节炎
分类号:
R684.3; R446.1
DOI:
10.3969/j.issn.1671-7414.2015.03.043
文献标志码:
A
摘要:
目的 研究不同炎症标志物在不同类型关节炎中的鉴别诊断价值。方法 2013年1月～2014年1月在沈阳军区总医院骨科病房住院患者中,33例感染性关节炎和29例痛风性关节炎病人中,检测血浆中白细胞数量、C反应蛋白以及尿酸水平和关节滑液中乳酸、葡萄糖、尿酸、乳酸脱氢酶、白细胞等相关炎症标志物,再通过受试者工作曲线分析不同标志物的诊断价值。结果 在两组患者中,只有血浆白细胞和C反应蛋白水平不存在统计学差异,关节滑液中乳酸浓度检测的诊断价值最高,曲线下面积(AUC)为0.898,特异度为72.4%,敏感度为96.9%; 其次为血清尿酸和滑液尿酸两项指标,AUC分别为0.818和0.808。结论 在感染性关节炎中乳酸标志物有良好的诊断价值,滑液中乳酸水平高于1.7 mmol/L基本可以诊断为感染性关节炎。
Abstract:
Objective The aim of this study was to investigate which inflammatory markers allow an accurate differentiation of septic and gouty arthritis.Methods In 2013 January to 2014 January 33 patients with septic arthritis and 29 patients with gouty arthritis.Detectedwhite blood cells,C-reactive protein and uric acid of inflammatory markers inplasma and tested lactate,glucose,uric acid,lactate dehydrogenase and white blood cell count inflammatory markers in the synovial fluid.MedCalc 13.0 software were used for statistical analysis.Results There wereno significantly different between serum C-reaction protein and WBC counts with two groups.Synovial lactate showed the greatest diagnostic potential(AUC=0.898,sensitivity=96.9%,specificity=72.4%)followed by serum uric acid(AUC=0.818)and synovial uric acid(AUC=0.808).Conclusion Lactate in the synovial fluid has excellent diagnostic potential to differ septicarthritis from gouty arthritis.Synovial lactate levers above 1.7 mmol/L almost proofed septic arthritis.

参考文献/References:

[1] Eberst-Ledoux J,Tournadre A,Mathieu S,et al.Septic arthritiswith negative bacteriological findings in adult native joints:a retrospectivestudy of 74 cases[J].Joint Bone Spine,2012,79(2):156-159.
[2] Fottner A,Birkenmaier C,von Schulze Pellengahr C,et al.Can serum procalcitonin help to differentiate between septic and nonseptic arthritis?[J].Arthroscopy,2008,24(2):229-233.
[3] Li SF,Henderson J,Dickman E,et al.Laboratory te-sts in adults with monoarticular arthritis:can they rule out a septic joint?[J].Acad Emerg Med,2004,11(3):276-280.
[4] McGillicuddy DC,Shah KH,Friedberg RP,et al.How sensitive is the synovial fluid white blood cell count in diagnosing septic arthritis?[J].Am J Emerg Med,2007,25(7):749-752.
[5] Abdelnour A,Bremell T,Holmdahl R,et al.Clonal expansion of T lymphocytes causes arthritis and mortality in mice infected with toxic shock syndrome toxin-1-producing staphylococci[J].Eur J Immunol,1994,24(5):1161-1166.
[6] Mathews CJ,Coakley G.Septic arthritis:current diagnostic and therapeutic algorithm[J].Curr Opin Rheumatol,2008,20(4):457-462.
[7] Kumar S,Gow P.A survey of indications,results and complications of surgery for tophaceous gout[J].N Z Med J,2002,115(1158):U109.
[8] Lee SS,Lin SD,Lai CS,et al.The soft-tissue shaving procedure for deformity management of chronic tophaceous gout[J].Ann Plast Surg,2003,51(4):372-375.
[9] Lee SS,Sun IF,Lu YM,et al.Surgical treatment of the chronic tophaceous deformity in upper extremities-the shaving technique[J].J Plast Reconstr Aesthet Surg,2009,62(5):669-674.
[10] Soderquist B,Jones I,Fredlund H,et al.Bacterial or crystal-associated arthritis? Discriminating ability of serum inflammatory markers[J].Scand J Infect Dis,1998,30(6):591-596.
[11] Brook I,Reza MJ,Bricknell KS,et al.Synovial fluid lactic acid.A diagnostic aid in septic arthritis[J].Arthritis Rheum,1978,21(7):774-779.
[12] Riordan T,Doyle D,Tabaqchali S.Synovial fluid la-ctic acid measurement in the diagnosis and management of septic arthritis[J].J Clin Pathol,1982,35(4):390-394.
[13] Smith JW,Piercy EA.Infectious arthritis[J].Clin In-fect Dis,1995,20(2):225-230; quiz 231.
[14] Shmerling RH, Delbanco TL, Tosteson AN,et al.Synovial fluid tests.What should be ordered?[J].JAMA,1990,264(8):1009-1014.

备注/Memo

备注/Memo:
作者简介:万 楠(1978-),男,硕士学位,副主任技师,研究方向:心血管疾病发病风险分析,Tel:13352452082,E-mail:wannan@ymail.com。
通讯作者:胡晓芳(1963-),女,硕士学位,主任技师,研究方向:脑血管病变机制,Tel:13309888903,E-mail:syplay@me.com。
更新日期/Last Update: 2015-06-10