中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (3): 319-323.doi: 10.3969/j.issn.2095-4344.2016.03.003

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

含抗生素可活动关节骨水泥对全膝关节置换过程中血沉、C-反应蛋白及关节功能的影响

李国华，丁黎明，张 斌，邱 静，刘 含   

  1. 山东省东阿县人民医院，山东省东阿县 252201
  • 收稿日期:2015-11-30 出版日期:2016-01-15 发布日期:2016-01-15
  • 作者简介:李国华，男，1967年生，山东省东阿县人，汉族，医师，主要从事关节置换、韧带重建的研究。

Effect of antibiotic-loaded bone cement on erythrocyte sedimentation rate, C-reactive protein level and joint function of patients undergoing total knee arthroplasty

Li Guo-hua, Ding Li-ming, Zhang Bin, Qiu Jing, Liu Han
  

  1. the People’s Hospital of Donge Country in Shandong Province, Donge 252201, Shandong Province, China
  • Received:2015-11-30 Online:2016-01-15 Published:2016-01-15
  • About author:Li Guo-hua, Physician, the People’s Hospital of Donge Country in Shandong Province, Donge 252201, Shandong Province, China

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摘要：

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文题释义：
抗生素骨水泥：在骨水泥中掺入抗生素，使之在局部有高浓度抗生素而减少术后感染或治疗人工关节置换后感染。既往研究表明，不同抗生素种类、添加量和比例不同，不仅可影响抗生素的释放速度和浓度，更重要的是影响骨水泥的强度和弹性模量。

关节置换后感染的诊断：除了影像学诊断外，还需要测定患者血沉和C-反应蛋白。血沉检查并不会针对某种疾病，但对判断机体是否存在炎症有重要价值。C-反应蛋白是一种能够与肺炎球菌多糖体反应的一种蛋白质，也是检测炎性指标之一。研究C-反应蛋白和血沉在判断早期感染和预后有重要意义。  

 

背景：在骨水泥中混入抗生素并对人工关节进行固定，能在局部发挥抗生素的抗感染作用，起到预防感染发生的效果。
目的：观察含抗生素可活动关节骨水泥对全膝关节置换患者血沉、C-反应蛋白及关节功能的影响。
方法：纳入膝关节置换患者86例，其中男43例，女43例，年龄45-75岁，采用随机数字表法分为观察组和对照组，每组43例。观察组采用含抗生素可活动关节骨水泥固定人工膝关节，对照组采用常规骨水泥固定人工膝关节，比较两者手术情况、血液指标、膝关节功能及治疗效果。

结果与结论：观察组术后卧床时间、感染发生率明显低于对照组(P < 0.05)，治疗后2周的屈膝角度、治疗总有效率明显高于对照组(P < 0.05)。两组治疗后3，7 d的C-反应蛋白、血沉水平较治疗前明显降低(P < 0.05)，且观察组低于对照组(P < 0.05)。两组治疗后6个月的膝关节功能评分较治疗前显著升高(P < 0.05)，且观察组高于对照组(P < 0.05)。表明含抗生素可活动关节骨水泥有助于预防感染的发生，改善血液指标，促进膝关节功能恢复。 

关键词: 生物材料, 骨生物材料, 抗生素, 全膝关节置换, 骨水泥, 血沉, C-反应蛋白, 关节功能

Abstract:

BACKGROUND: Antibiotic-loaded bone cement for artificial joint fixation can locally play the anti-inflammatory effects of antibiotics, thereby preventing the occurrence of infection.
OBJECTIVE: To investigate the effect of antibiotic-loaded bone cement on erythrocyte sedimentation rate, C-reactive protein and joint function of patients treated by total knee arthroplasty.
METHODS: Totally 86 patients, including 43 males and 43 females, aged 45-75 years, were enrolled and divided into observation and control groups (n=43/group). The artificial knee joints of patients in the
observation group were fixed with antibiotic-loaded bone cement, while the artificial knee joints of patients in the in the control group were fixed with conventional bone cement. The surgical condition, blood indexes, knee function and therapeutic efficacy were compared between these two groups.
RESULTS ADN CONCLUSION: The bed time and incidence of infection after operation in the observation group were significantly lower than those in the control group (P < 0.05); the knee bending angle and total efficiency of treatment after 2 weeks of treatment were significantly higher than those in the control group (P < 0.05). The C-reactive protein level and erythrocyte sedimentation rate at 3 and 7 days after treatment in these two groups were significantly decreased compared with those before treatment (P < 0.05), especially in the observation group (P < 0.05). The knee joint function scores after 6 months of treatment in these two groups were significantly increased compared with those before treatment (P < 0.05), especially in the observation group (P < 0.05). These results demonstrate that antibiotic-loaded bone cement is conductive to prevent the occurrence of infections, improve blood indexes and promote the knee joint function recovery.