CAJ | 학술논문

目的：探讨超敏C反应蛋白（ hs-CRP ）和D-二聚体（ D-D ）在人工髋关节置换术前后患者血清中的表达变化及意义。方法：将本院60例人工髋关节置换术患者作为研究对象，分别在入院时、术前24h、术后24h 、72h、术后第7天、术后第14天分别抽取静脉血，测定两组患者血浆中hs-CRP及D-二聚体的浓度。结果：①术后24h 、术后72h的hs-CRP 及D-二聚体的浓度均高于入院时及术前24h，且差异具有统计学意义（ P＜0．05）；术后第14天时hs-CRP 浓度与术前无统计学差异（ P＞0．05），但D-二聚体的浓度与术前仍存在统计学差异（P＜0．05）。②4例患者术后72h出现感染症状，伤口局部疼痛，同期hs-CRP 浓度再次升高，与无感染症状患者比较，浓度具显著统计学差异（P＜0．01），经过抗感染治疗后4例患者hs-CRP 浓度有所下降，术后第14天时hs-CRP 浓度仍高于无感染症状患者。③5例患者经过彩色多普勒证实存在术后下肢深静脉血栓（ DVT ），术后第14天时仍高于无下肢深静脉血栓患者。④通过Logistic分析方法可知hs-CRP 与人工髋关节置换术感染的发生具有正相关关系，D-二聚体是人工髋关节置换术后下肢深静脉血栓的危险因子。结论：hs-CRP和D-D浓度的变化为早期DVT、术后感染的筛选提供理论依据。
목적：탐토초민C반응단백（ hs-CRP ）화D-이취체（ D-D ）재인공관관절치환술전후환자혈청중적표체변화급의의。방법：장본원60례인공관관절치환술환자작위연구대상，분별재입원시、술전24h、술후24h 、72h、술후제7천、술후제14천분별추취정맥혈，측정량조환자혈장중hs-CRP급D-이취체적농도。결과：①술후24h 、술후72h적hs-CRP 급D-이취체적농도균고우입원시급술전24h，차차이구유통계학의의（ P＜0．05）；술후제14천시hs-CRP 농도여술전무통계학차이（ P＞0．05），단D-이취체적농도여술전잉존재통계학차이（P＜0．05）。②4례환자술후72h출현감염증상，상구국부동통，동기hs-CRP 농도재차승고，여무감염증상환자비교，농도구현저통계학차이（P＜0．01），경과항감염치료후4례환자hs-CRP 농도유소하강，술후제14천시hs-CRP 농도잉고우무감염증상환자。③5례환자경과채색다보륵증실존재술후하지심정맥혈전（ DVT ），술후제14천시잉고우무하지심정맥혈전환자。④통과Logistic분석방법가지hs-CRP 여인공관관절치환술감염적발생구유정상관관계，D-이취체시인공관관절치환술후하지심정맥혈전적위험인자。결론：hs-CRP화D-D농도적변화위조기DVT、술후감염적사선제공이론의거。
Objective:To analyse the variation of high sensitivity C reactive protein ( hs-CRP ) and D-Dimer in the perioperation period of the artificial hip replacement , to explore the significance of the two inde-xes.Method:60 artificial hip replacement cases were chosen .Blood samples were get when the patient were admitted, 24h before the operation, 24h, 72h, 7 days and 14 days after the operation.Hs-CRP and D-Di-mer were detected for each time point .Result:①The levels of D-dimer and hs-CRP in 24h and 72h after the operation were much higher than those in admission and 24h before operation (P<0.05).The level of hs-CRP did not change significantly compare to the level before operation (P>0.05), but the D-dimer really change ( P<0.05) .②4 cases had inflammatory symptoms 72h after the operation .The hs-CRP of those 4 ca-ses elevated to a higher level than the no-inflammatory cases ( P<0.01) .After anti-inflammatory treatment , the hs-CRP level declined .While 14 days after the operation , the hs-CRP level of the 4 cases were still higher than no-inflammatory cases .③5 cases had confirmed deep vein thrombus ( DVT) by color doppler ul-trasound .They had higher D-dimer level even 14 days after the operation .④By logistic analysis , it was proved that hs-CRP had positive correlation with the occurrence of perioperative inflammation , D-dimer was a risk factor for the DVT after the operation of artificial hip replacement .Conclusion: The variation and sig-nificance of hs-CRP and D-dimer were the theoretical basis of early DVT , perioperative inflammation in ar-tificial hip replacement .