The Change Pattern Of C-reactive Protein And Erythrocyte Sedimentation Rates Of The Diabetic With The Primary Hip Arthroplasty

Objective:Our study is to investigate the change pattern of C-reactive protein (CRP) anderythrocyte sedimentation rates (ESR) of the diabetic and non-diabetic patients withhip diseases before and after the first artificial total hip arthroplasty, as well as thecorrelation of CRP and ESR with the operation methods and glycemic control indiabetic group. The conclusion may provide a useful reference for hip arthroplastyperioperative monitor in diabetic patients.Methods:The study design method is retrospective. The data of the diabetic andnon-diabetic patients with hip diseases whose first accept the artificial hip jointarthroplasty were collected from The First and Second Affiliated Hospital OfNanchang University from October2011to December2013. Among the inclusivecriteria,66patients were enrolled in diabetic group,23were male and43were female,as well as non-diabetic patients were also66,25were male and41were female. Inboth group, fasting venous blood CRP and ESR were examined in the morning beforethe operation and on1st,3rd,7th and14th day after operation. According to the bloodglucose level, the diabetic patients were divided into two groups--well glycemiccontrol group (46cases)and poor control group (20cases), and these patients werealso divided into two groups on the basis of different surgical procedure--total hiparthroplasty group (39cases) and heriarthroplasty group (27cases).Results:The level of CRP and ESR were elevated in different time after total hiparthroplasty of the diabetic and non-diabetic group, and there has a statisticalsignificance in before and after operation(P<0.05). CRP level reached the peak on the3rd day and then slowed down gradually to preoperative basal level on10th day. ESRlevel culminated on the5th day and declined more slowly than CRP. However, thelevel of ESR after operation was higher than before operation was statistically significant. In diabetic group, there have significant differences（P<0.05) about thelevel of the CRP and ESR between the poor glycemic control group and the wellcontrol group. Nevertheless, the CRP and ESR level of the patients who received totalhip arthroplasty were not different from those who received heriarthroplasty(P>0.05).Conclusion:There is a certain variation pattern of the CRP and ESR level in the patients whohave hip joint arthroplasty. Compare diabetic group with non-diabetic group, wefound that results of the peak level and different time level of the CRP and ESR weresignificant, indicated that postoperative CRP and ESR controlled at low levels mayreduce inflammation reaction and infection rates. Meanwhile, the change pattern ofthe CRP and ESR may provide benefit reference to detect and intervene early forinfection and to evaluate the effectiveness of infection control. Monitor index ofinflammation serum CRP level was change faster and goes back to normal levelfaster than ESR. Dynamic monitoring of ESR and CRP would quickly discoverearly inflammation. These two items should be routinely monitored duringperioperative period of hip joint arthroplasty, and they can also be used to assess therecovery condition and other complications. Glycemic control in diabetic patients hasan effect on the level of CRP and ESR, but different surgical methods were not.