白细胞酯酶诊断关节假体感染的意义

Significance of leucocyte esterase in diagnosis of periprosthetic joint infection

摘要:

关节假体周围感染（periprosthetic joint infection, PJI） 是关节置换术后灾难性的并发症，一旦发生，会给患者带来很大的心理和经济负担。所以及时且正确的诊断很重要。目前常用的诊断方法根据临床表现、影像学表现、血清与滑液标记物等制定，随着更多的血清与滑液标记物的发现与实验，生化指标检查日益重要，有些滑液标记物易受到炎症的影响。近年来白细胞酯酶（leukocyte esterase, LE） 逐渐被重视，LE 有较高的敏感性和特异性。因此，应结合其他临床评价和辅助检查来诊断。LE 水平的影响需要进一步研究。本文综合分析目前有关滑液LE 的临床研究，对其在PJI 诊断中的研究现状和临床价值进行综述。

Abstract:

Periprosthetic joint infection (PJI) is a catastrophic complication after arthroplasty. Once it happens, it will bring great psy-chological and economic burden to patients, so timely and correct diagnosis is crucial. At present, the commonly used diagnostic methods areformulated according to clinical manifestations, imaging manifestations, serum and synovial biomarkers, etc. With the discovery and experi-ment of more serum and synovial biomarkers, the examination of biochemical indicators become increasingly important, regardless of somesynovial biomarkers easily affected by inflammation. In recent years, leukocyte esterase has been paid more and more attention, which hashigh sensitivity and specificity for diagnosis of PJI, despite of that other clinical evaluations and auxiliary examinations should be combinedin the diagnosis. Effectiveness of leukocyte esterase for diagnosis of PJI need further research. This article comprehensively analyzes the cur-rent clinical research on synovial leucocyte esterase, and reviews its research status and clinical value in the diagnosis of PJI.