Анализ биохимических показателей сыворотки крови у больных с ревизионным эндопротезированием тазобедренного сустава и нарушением углеводного обмена

Abstract

INTRODUCTION: Along with increase in the number of hip arthroplasty surgeries, the number of complications after them also increases. Laboratory diagnostics, being a unified method for determining the risks of complications and relapses, indicates the need for a comparative analysis of standard laboratory parameters in patients with carbohydrate metabolism disorders (CMD) before revision arthroplasty. AIM: To evaluate changes in the biochemical parameters of blood serum of patients with impaired carbohydrate metabolism before revision arthroplasty. MATERIALS AND METHODS: The data of anamnesis, morphometry and main blood parameters of patients who underwent treatment for osteoarticular pathology and purulent osteology in inpatient facility from 2011 to 2019 were processed and analyzed. The first group included 115 patients (33% of the total amount of examined patients) with revision hip arthroplasty having no disorders in carbohydrate metabolism in history. The second group included 103 patients (30%) who underwent revision hip arthroplasty and had diabetes mellitus, impaired glucose tolerance, and early forms of carbohydrate metabolism disorders as comorbidities. The third group included 73 patients (21%) with periprosthetic infection of the hip joint without history of carbohydrate metabolism disorders. The fourth group included 56 patients (16%) with periprosthetic infection, with disorders of carbohydrate metabolism. RESULTS: The results obtained in the study groups were intercompared and compared with the reference intervals established by the reagent manufacturers for each study method. In the studies, no statistically significant differences were found in the biochemical parameters of blood of patients with aseptic revision arthroplasty, depending on the existing disorders of carbohydrate metabolism. When comparing biochemical parameters of blood of patients with periprosthetic infection, statistically significant differences depending on the presence of CMD, were found in three parameters. Patients with disorders of carbohydrate metabolism had higher blood levels of glucose, creatinine and urea, which, however, remained within the normal range. Two biochemical parameters of the blood of patients of all four groups were beyond the standard limits — C-reactive protein and albumin-globulin ratio. In patients with endoprosthesis instability, bilirubin, creatinine, and albumin values changed depending on the presence of an infectious process in the joint, and creatinine and urea, depending on carbohydrate metabolism disorders. CONCLUSIONS: Depending on the presence of an infectious process or disorders of carbohydrate metabolism, these parameters require closer attention in the preoperative period in patients with endoprosthesis instability. Patients with periprosthetic infection of the hip joint with carbohydrate metabolism disorders require laboratory monitoring of kidney function, protein fractions, and C-reactive protein even with normal results of biochemical blood tests.