南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (02): 190-.

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界膜组织细菌16S rRNA和23S rRNA对假体周围感染的诊断意义

安森博，蔡碰德，汪龙，胡懿郃   

  • 出版日期:2016-02-20 发布日期:2016-02-20

Value of detecting bacterial 16S and 23S rRNA in interface membrane in diagnosis of periprosthetic joint infection

  • Online:2016-02-20 Published:2016-02-20

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摘要： 目的对界膜组织中细菌16S rRNA、23S rRNA进行PCR检测，分析比较两者单独以为及联合应用于假体周围感染诊断的
效率。方法应用诊断标准对本机构67例髋关节翻修患者是否患有假体周围感染（PJI）作出诊断；用PCR技术检测各界膜组织
中细菌16S rRNA和23S rRNA 基因片段的表达，同样对PJI作出诊断。分别将16S rRNA、23S rRNA、16S rRNA/23S rRNA（即
16S rRNA或23S rRNA检测一项为阳性结果即可）以及16S rRNA+23S rRNA 4种策略的诊断结果与诊断标准的结果比较，分
析4种策略的敏感性、特异性、阳性及阴性预测值、准确性的差异。结果应用16S rRNA/23S rRNA诊断的敏感性和阴性预测值
均高于16S rRNA+23S rRNA（95.7% vs 52.2%，P<0.01；97.6% vs 79.6%，P=0.01）。4种诊断策略的特异性、阳性预测值以及准确
性无显著性差异，单独应用16S rRNA或23S rRNA的诊断效率相当。结论单独应用16S rRNA或23S rRNA进行诊断的效率
明显差异，16S rRNA/23S rRNA较16S rRNA+23S rRNA更为敏感，且阴性结果可信度更高。

Abstract: Objective To explore the value of detecting bacterial 16S rRNA with 23S rRNA in the diagnosis of periprosthetic joint
infection (PJI). Methods A prospective study was conducted among 67 patients with previous total hip arthroplasty (THA)
undergoing a reoperation for infection (23 patients) or aseptic loosening (44 patients). Bacterial 16S rRNA and 23S rRNA in the
interface membrane were detected by real-time PCR and their value in diagnosis of PJI was assessed. Results The 16S rRNA
and 23S rRNA showed no significant difference in their power in the diagnosis of PJI. The detection of 16S rRNA/23S rRNA
showed a higher sensitivity and a greater negative predictive value in PJI diagnosis than the detection of 16S rRNA+23S rRNA
(95.7% vs 52.2%, P<0.01; 97.6% vs 79.6%, P=0.01). The specificity, positive predictive value, and accuracy of the 4 diagnostic
strategies were not significantly different. Conclusion The diagnostic power of 16S rRNA and 23S rRNA was similar in
detecting PJI. Compared with the diagnostic strategy with 16S rRNA+ 23S rRNA, 16S rRNA/23S rRNA is more sensitive in
detecting PJI.