中性粒细胞与淋巴细胞比值联合C反应蛋白对GustiloⅡ型开放骨折术后短期感染的预测价值OA
Predictive value of neutrophil-to-lymphocyte ratio combined with C-re-active protein for short-term postoperative infection in Gustilo type Ⅱopen fractures
目的 探讨入院时中性粒细胞与淋巴细胞比值(NLR)联合 C 反应蛋白(CRP)对 GustiloⅡ型开放骨折术后短期感染的预测价值.方法 回顾性分析 2024 年 1 月至 2025 年 1 月兰州大学第二医院急诊创伤外科行急诊清创+骨折固定术的 GustiloⅡ型开放性骨折 62 例患者的临床资料,按照住院期间检查结果是否发生感染分为感染组和无感染组,收集性别、年龄、体重指数(BMI)、糖尿病史、入院时血常规、CRP及术后短期感染情况等数据并计算NLR.比较感染组与无感染组各指标差异,采用 ROC 曲线分析 NLR 联合 CRP 对术后短期感染的预测价值.结果 GustiloⅡ型开放性骨折患者急诊行清创+固定术后,短期感染发生率为 32.25%(20 例);感染组术前 NLR、CRP 水平高于无感染组,差异有统计学意义(P＜0.05);两组患者年龄、性别、糖尿病史、BMI 比较,差异无统计学意义(P＞0.05).ROC曲线分析显示,NLR、CRP单独预测术后短期感染的曲线下面积(AUC)分别为 0.696、0.780,预测价值较低;NLR 联合CRP的 AUC为 0.849,对术后短期感染具有较高预测价值.结论 GustiloⅡ型开放性骨折患者急诊入院时外周血 NLR、CRP 升高,术后短期感染风险更高;而且 NLR 与 CRP 联合检测可显著提升对术后短期感染的预测价值.
Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR)combined with C-reac-tive protein(CRP)at admission for short-term postoperative infection in patients with Gustilo type Ⅱ open fractures.Meth-ods A retrospective analysis was conducted on the clinical data of 62 patients with Gustilo type Ⅱ open fractures who un-derwent emergency debridement and fracture fixation in the Department of Emergency Trauma Surgery,Lanzhou University Second Hospital from January 2024 to January 2025.They were divided into the infection group and the non-infection group based on whether postoperative infection occurred according to the in-hospital examination results.Data includ-ing gender,age,body mass index(BMI),history of diabetes mellitus,admission routine blood test results,CRP levels,and short-term postoperative infection status were collected,and the NLR was calculated.Differences in various indica-tors between the infection group and the non-infection group were compared.The predictive value of NLR combined with CRP for short-term postoperative infection was analyzed using the receiver operating characteristic(ROC)curve.Results The incidence of short-term postoperative infection was 32.25%(20 cases)in patients with Gustilo type Ⅱ open fractures after emergency debridement and fixation.Preoperative NLR and CRP levels in the infection group were higher than those in the non-infection group,with statistically significant differences(P＜0.05).There were no significant differences in age,gender,history of diabetes,or BMI between the two groups(P＞0.05).ROC curve analysis showed that the areas under the curve(AUC)of NLR and CRP alone for predicting short-term postoperative infection were 0.696 and 0.780,respectively,indicating low predictive value,the AUC of NLR combined with CRP was 0.849,showing a high predictive value for short-term postoperative infection.Conclusion Elevated peripheral blood NLR and CRP at emergency admission are asso-ciated with a higher risk of short-term postoperative infection in patients with Gustilo type Ⅱ open fractures.Moreover,combined detection of NLR and CRP can significantly improve the predictive value for short-term postoperative infection.
马东红;成鹏
兰州大学第二医院急诊创伤外科病区,甘肃 兰州 730030兰州大学第二医院急救中心,甘肃 兰州 730030
医药卫生
中性粒细胞与淋巴细胞比率C反应蛋白GustiloⅡ型开放骨折术后短期感染
Neutrophil-to-lymphocyte ratioC-reactive proteinGustilo type Ⅱ open fractureShort-term postoperative infection
《中国当代医药》 2026 (12)
20-25,6
评论