【摘要】 目的 探讨膝关节置换术后患者血清核因子-κB受体活化因子配基（RANKL）、可溶性血管细胞黏附分子-1(sVCAM-1)、红细胞沉降率（ESR）的表达意义及其与预后的关系。方法 回顾性分析2020年1月至2022年9月安阳市人民医院收治的118例膝关节置换手术患者的临床资料，根据术后6个月Lysholm评分将患者分为预后不良组（总分<70分，27例）和预后良好组（总分≥70分，91例）。比较两组术后1、3个月血清RANKL、sVCAM-1、ESR表达水平，分析其与Lysholm评分的相关性，评估上述血清学指标联合检测对患者术后预后不良的预测价值。结果 术后1、3个月预后不良组血清RANKL、sVCAM-1、ESR水平高于预后良好组（P <0.05），术后1、3个月血清RANKL、sVCAM-1、ESR水平与Lysholm评分呈负相关（P <0.05），联合预测患者术后预后不良的曲线下面积（AUC）优于各血清指标单独预测（P <0.05）。结论 血清RANKL、sVCAM-1、ESR水平升高可提示膝关节置换术患者预后不良风险的增加，联合检测可作为预测预后不良、判断病情转归的参考依据。更多还原

【Abstract】 Objective To investigate the expression significance of serum receptor activator of nuclear factor-kappa B ligand(RANKL), soluble vascular cell adhesion molecule-1(sVCAM-1), and erythrocyte sedimentation rate(ESR) in patients after knee arthroplasty, and their relationships with prognosis. Methods Clinical data of 118 patients who underwent knee arthroplasty in Anyang People’s Hospital from January 2020 to September 2022 were retrospectively analyzed. Based on 6-month postoperative Lysholm score, the patients were categorized into a poor prognosis group(27 patients, Lysholm score less than 70 points) and a good prognosis group(91 patients, Lysholm score more than or equal to 70 points). Expression levels of serum RANKL,sVCAM-1, and ESR were compared between the two groups at 1, 3 months postoperatively, their correlations with Lysholm scores were analyzed, and the predictive value of poor prognosis of combined detection of the above serum markers were evaluated for patients after knee arthroplasty. Results Compared with those in the good prognosis group, the levels of serum RANKL, sVCAM-1 and ESR in the poor prognosis group were higher at 1 and 3 months after operation(P < 0.05). Serum RANKL, s VCAM-1 and ESR levels were negatively correlated with Lysholm score at 1 and 3 months postoperatively(P < 0.05). The area under curve(AUC) of the combined prediction of serum RANKL, sVCAM-1, and ESR levels for poor prognosis was superior to that of each serum marker alone(P < 0.05). Conclusion For patients after knee arthroplasty, elevated levels of serum RANKL, s VCAM-1 and ESR could reveal a increased risk of poor prognosis, furthermore, the combined detection of the serum markers could provide references for poor prognosis prediction and outcome judgement.更多还原