Expression and predictive value of serum SDF-1,sCD14-ST and TLR-4 in infection after bone and joint replacement
OBJECTIVE To investigate the expression and predictive value of serum stromal cell-derived factor-1(SDF-1),soluble leukocyte differentiation antigen 14 subtype(sCD14-ST)and Toll-like receptor 4(TLR-4)lev-els in patients with infection after bone and joint replacement.METHODS A total of 61 patients with infection after bone and joint replacement admitted to the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine and Fuzhou First Hospital Affiliated to Fujian Medical University from Mar 2021 to Mar 2023 were selected as the infection group,and 61 patients without infection after bone and joint replacement during the same period were selected as the non-infection group.The risk factors of postoperative infection in patients with bone and joint replacement were analyzed by logistic regression analysis,and the serum levels of SDF-1,sCD14-ST and TLR-4 between the non-infected group and the infected group were compared.Receiver operating charac-teristic(ROC)curve was used to analyze the diagnostic value of serum SDF-1,sCD14-ST and TLR-4 levels in pa-tients with postoperative infection after bone and joint replacement.RESULTS Logistic analysis showed that age,long-term use of hormone drugs,complicated diabetes mellitus,operation time,postoperative drainage time,al-bumin ≤35 g/L were the risk factors for postoperative infection in patients with bone and joint replacement(P＜0.05).The expression levels of serum SDF-1,sCD14-ST and TLR-4 in the infected group were higher than those in the non-infected group(P＜0.05).The AUC value of combined detection of serum SDF-1,sCD14-ST,and TLR-4 expression levels in the diagnosis of postoperative infection in patients undergoing bone joint replacement was higher than that of single detection(P＜0.05),and the sensitivity and specificity of combined detection were 90.16％and 75.41％,respectively.CONCLUSION Postoperative infection in patients with bone and joint replacement is related to age,long-term use of hormone drugs,diabetes mellitus,operation time,postoperative drainage time and albu-min level.Serum SDF-1,sCD14-ST and TLR-4 levels are highly expressed in postoperative infection in patients with bone and joint replacement,and the combined detection of these three indexes can improve the value in diagnosis of infection.
Bone and joint replacementPostoperative infectionRisk factorStromal cell derived factor-1Solu-ble leukocyte differentiation antigen 14 subtypeToll-like receptor 4Receiver operating characteristic curve
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