인공 고관절 치환술 후 적혈구 침강속도(ESR) 및 C -반응성 단백질(CRP)의 변화

초록

Purpose: Fever and leukocytosis are commonly used indicators of infection but are nonspecific and can be influenced by several factors other than infection. Although changes of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are currently being used as the standard laboratory tests for the assessment of infection, very few studies have evaluated their application in total hip arthroplasty (THA). The authors evaluated the levels of ESR and CRP after THA to define the value of these two tests as indicators of infection after THA. Materials and methods: We analyzed 94 primary THA and 47 revision THA. None of the cases had any clinical evidence of infection. The serum levels of ESR and CRP were determined preoperatively and postoperatively at 1, 3, 7, 14, 30, 60, 90 and 180 days in all the cases. Results: The mean ESR increased to a maximum (51.5 mm/hr in primary THA, 55.7 mmg/hr in revision THA) on the 3rd day postoperatively after which it decreased gradually and returned to normal level in the first postoperative month. The level of CRP was remarkably high (90.4 mg/l in primary THA and 102.4 mg/l in revision THA) on the 3rd day postoperatively after which it also began to fall more rapidly and returned to normal level in the 2nd week postoperatively. CRP was not influenced by age or sex. Conclusion: Measurement of both ESR and CRP is helpful in the detection of infection after THA, but the level of CRP is more sensitive and informative than ESR.

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