The Clinical Application Of D-dimer In The Diagnosis Of Chronic Prosthetic Infection

Objective:To investigate the diagnostic significance of serum d-dimer,C-reactive protein,erythrocyte sedimentation rate,fibrin degradation products and fibrinogen in chronic Periprosthetic Joint Infection.Methods:A retrospective study of 106 patients with chronic prosthesis peripheral infection,aseptic loosening,and osteoarthritis in the Department of Osteoarthritis,Second Hospital of Shanxi Medical University from June 2018 to June 2020,76 cases were finally included according to strict inclusion and exclusion criteria The patients were divided into three groups according to the type of operation: 20 patients in group A underwent primary infection exclusion + secondary revision;26 aseptic loosening patients in group B underwent primary arthroplasty;30 patients in group C had bones and joints Patients with inflammation underwent initial total knee or total hip replacement.Kruskal-Wallis H test was used to evaluate the application value of serum d-dimer among the three groups,and receiver operating curve(ROC)analysis was used to statistically evaluate serum d-dimer,C-reactive protein,erythrocyte sedimentation rate,and fiber The diagnostic efficacy of protein degradation products and fibrinogen and other indicators.Results:There was no statistical difference in the general data of the three groups of patients,such as gender,age,and body mass index.The d dimer level of the infection group was935(753,1250)ng/m L,which was higher than the 152(122,288)ng/m L of the loosening group and 127(96,195)ng/m L of the normal group.The difference was both Statistically significant(Z=4.83,P<0.05;Z=5.09,P<0.05).The infection group was used as the experimental group,and the other two groups were used as the control group.ROC curve analysis of each inflammatory index showed that the optimal threshold of d-dimer for the diagnosis of chronic prosthetic infection was 397 ng/m L,and the sensitivity was 94.12%.The specificity is 93.33%,and the AUC is 0.964;the best threshold of C-reactive protein is4.72 mg/L,the sensitivity is 100.00%,the specificity is 91.11%,and the AUC is 0.786;the best threshold of erythrocyte sedimentation rate is 43mm/h,and the sensitivity is 70.59%The specificity is 95.56%,and the AUC is 0.812;the optimal threshold for fibrin degradation products is 2.66ug/ml,the sensitivity is 100.00%,the specificity is 88.89%,and the AUC is 0.786;the optimal threshold for fibrinogen is 3.64g/L,The sensitivity is47.06%,the specificity is 95.56%,and the AUC is 0.786.Conclusion:Patients with chronic peripheral prosthetic infection have higher serum d-dimer levels,which is a promising indicator for the diagnosis of Periprosthetic Joint Infection.