探讨行初次单侧全髋关节置换术(THA)或全膝关节置换术(TKA)术后的骨关节炎(OA)患者，出院时C反应蛋白(CRP)水平和发生假体周围感染(PJI)的关联性。

2013年01月至2015年12月，东南大学附属中大医院骨科共收治480例因OA行初次单侧THA或TKA术的患者。纳入标准为术前CRP水平正常；排除标准包括术前有感染病史者、合并有糖尿病、恶性肿瘤等。根据出院时血清CRP水平，分为高CRP组(273例)和正常CRP组(207例)。所有患者出院时血象和体温正常、伤口清洁干燥，出院后不使用任何抗生素或非甾体抗炎药(NSAIDs)。统计随访期间内发生PJI的例数和时间。计量资料采用t检验，PJI发病率的比较采用卡方检验或Fisher确切概率法。

两组患者的性别、年龄和出院时间的差异比较均无统计学意义(P>0.05)。415例患者获得随访，随访时间平均(18± 3)个月。两组在末次随访时各有3例、2例患者发生了PJI，发病率差异比较无统计学意义(χ²＝0.023，P>0.05)。

行初次单侧THA或TKA术后的OA患者，出院时CRP水平和PJI发病率可能无关联性，但应加强对出院时CRP水平较高患者的密切随访。

To investigate the relationship between discharge C-reactive protein (CRP) level of osteoarthritis (OA) patients and periprosthetic joint infection (PJI) after primary unilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA).

From January 2013 to December 2015, 480 OA patients receiving primary unilateral THA or TKA were admitted in department of Orthopedics of Zhongda Hospital Southeast University. The inclusion criteria were normal CRP level before operation, and exclusion criteria were preoperative history of infection, diabetes mellitus, malignant tumors, ect. The patients were divided into the high CRP group (273 cases) and the normal CRP group (207 cases) based on serum CRP level at discharging. Both groups were matched for known confounding factors such as sex, age and discharge time. The hemogram, temperature and wounds of all the patients were normal at discharge, and no antibiotic or NSAIDs were used after discharge. Cases and occurrence time of PJI were recorded during the follow-up. The measurement date were tested by t test, and the incidence of PJI was compared by chi-square test or Fisher’s exact probability method.

Both groups were matched for known confounding factors such as sex, age and discharge time. A total of 415 cases were followed-up after discharge, ranging from 13 to 26 months (18±3) months on average. Although there were three and two PJI cases in both groups respectively at the last follow-up, the results indicated no significant difference in incidence rate of PJI (χ²=0.023, P>0.05). The occurrence time of PJI in the high CRP group was shorter than that in the normal CRP group obviously, and the higher CRP level at discharge, the shorter occurrence time of PJI.

There may be no relationship between discharge CRP level of OA patients and incidence rate of PJI after primary unilateral THA or TKA, however, the patients with high discharge C-reactive protein level should be closely followed up.