Clinical Significance Of C-reactive Protein Level Before And After Artificial Joint Replacement Of Phlegmatic Hygrosis Body Constitution

ObjectiveTo investigate the distribution of C-reactive protein of the patients who were in phlegmatic hygrosis body constitution before and after artificial joint replacement, and its correlation with different gender, age, diseases, surgical procedures and other factors. To provide references to perioperative monitoring of artificial joint replacement on the patients who were in phlegmatic hygrosis body constitution.MethodsAccording to the criteria of phlegmatic hygrosis body constitution set by Professor Wang Qi with Beijing University of Traditional Chinese Medicine,53cases were selected between September2011and April2012, which met the standards of phlegmatic hygrosis body constitution and had artificial joint replacement in the third orthopedics service of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. Including21males and32females, their age were from38to81years, mean age was59years.35cases had total hip replacement, while the other18were performed knee replacement. C-reactive protein (CRP) and erythrocyte sedimentation rates were examined before meal in the morning by venous blood before the operation and on the1st,3rd,7th and14th day after operation. Strictly in accordance with the operating instructions, using immune scatter turbidity method to examine CRP and its normal value should be less than10mg/L. The detection of the ESR adopt the method with West Glen. Its normal value should be less than20mm/H.ResultsAdopting variance analysis by the SPSS13.0and comparing with the level of CRP before operation, it was significantly increased (P<0.05) on the1st and3rd day after operation among these53patients who were in phlegmatic hygrosis body constitution with the joint replacement, and the difference was statistically significant. Its level reached the peak on the3rd day and then appeared biphasic declines. The first phase was characterized by the rapid decline, appearing in the3rd to7th days. The second phase showed gradually slow decline. Comparing with the level of ESR before operation, it was significantly increased (P<0.05) on the1st,3rd and7th day after operation, and the difference was statistically significant. It slowed down gradually after the7th day when it reached the peak. The levels of CRP and ESR of the patients who performed total knee replacement were significantly higher than those who performed total hip replacement, and they reached the peak at the same time. These two groups were significantly different (P<0.05). There was no significant differences(P>0.05) of CRP level with different gender and age after operation, the same as the ESR level.ConclusionThere is a certain law in the dynamic changes of the CRP and ESR level in the patients who are in phlegmatic hygrosis body constitution with joint replacements. It was helpful to detect and intervene the infection early according to the normal curve of dynamic change. CRP is more sensitive than ESR. CRP and ESR dynamic monitoring can be used in the perioperative period of orthopedic operation as the routine to assess the postoperative recovery and whether the secondary infection or complications would happen. There are influences on expressions of postoperative CRP and ESR with different surgical methods and different type of diseases. The greater the surgical trauma, the higher levels of CRP and ESR are. The expressions of CRP and ESR have no correlation with gender and age.