红细胞免疫指标在老年股骨粗隆间骨折患者术后肺炎发生中的应用价值  

Application value of erythrocyte immune index in the occurrence of postoperative pneumonia in elderly patients with intertrochanteric fracture of femur

作　　者：李韶华 杜慧杰 张进一 常建设 李瑞峰 银晓永 LI Shaohua;DU Huijie;ZHANG Jinyi;CHANG Jianshe;LI Ruifeng;YIN Xiaoyong(Department of Clinical Laboratory,Jizhong Energy Fengfeng Group Co.,Ltd.General Hospital,Handan,Hebei 056000,China;Department of Pharmacy,Jizhong Energy Fengfeng Group Co.,Ltd.General Hospital,Handan,Hebei 056000,China;Department of Respiratory Medicine,Jizhong Energy Fengfeng Group Co.,Ltd.General Hospital,Handan,Hebei 056000,China;Department of Cardiology,Jizhong Energy Fengfeng Group Co.,Ltd.General Hospital,Handan,Hebei 056000,China;Department of Thoracic Surgery,Jizhong Energy Fengfeng Group Co.,Ltd.General Hospital,Handan,Hebei 056000,China;Department of Orthopedics,Jizhong Energy Fengfeng Group Co.,Ltd.General Hospital,Handan,Hebei 056000,China)

机构地区：[1]冀中能源峰峰集团有限公司总医院检验科,河北邯郸056000 [2]冀中能源峰峰集团有限公司总医院药剂科,河北邯郸056000 [3]冀中能源峰峰集团有限公司总医院呼吸科,河北邯郸056000 [4]冀中能源峰峰集团有限公司总医院心内科,河北邯郸056000 [5]冀中能源峰峰集团有限公司总医院胸外科,河北邯郸056000 [6]冀中能源峰峰集团有限公司总医院骨科,河北邯郸056000

出　　处：《国际检验医学杂志》2021年第12期1469-1472,1476,共5页International Journal of Laboratory Medicine

基　　金：河北省邯郸市科学技术研究与发展计划项目(1823208011ZC)。

摘　　要：目的研究红细胞免疫指标在老年股骨粗隆间骨折患者术后肺炎发生中的应用价值。方法选择2018年6月至2020年6月该院骨科收治的老年股骨粗隆间骨折患者770例为研究对象,将术后发生肺炎的46例患者纳入肺炎组,未发生其他任何感染的724例患者纳入对照组。分析白细胞计数(WBC)、红细胞免疫指标[红细胞补体受体1花环率(ECR1-RR)、红细胞补体受体1几何平均荧光强度(ECR1-GMFI)]与患者术后发生肺炎的相关性;分析患者术后发生肺炎的危险因素;分析ECR1-GMFI、WBC单独及联合检测对患者术后发生肺炎的诊断价值。结果WBC水平与患者术后肺炎发生呈正相关(r=0.550,P<0.05);ECR1-RR、ECR1-GMFI水平与患者术后肺炎发生呈负相关(r=-0.289、-0.313,P<0.05)。年龄>80岁、吸烟、WBC>10×10^(9)/L、贫血、标准化的ECR1-GMFI水平下降、美国麻醉医师协会分级≥Ⅲ级、手术时间≥60 min是患者术后发生肺炎的独立危险因素(P<0.05)。ECR1-GMFI联合WBC诊断患者术后发生肺炎的曲线下面积为0.984,灵敏度为96.32%,特异度为91.57%,高于2项指标单独检测。结论ECR1-GMFI是老年股骨粗隆间骨折患者术后发生肺炎的独立危险因素,且将其与WBC联合还可提高对患者术后肺炎发生的诊断效能。Objective To study the application value of erythrocyte immune indicators in the occurrence of postoperative pneumonia in elderly patients with intertrochanteric fracture of femur.Methods A total of 770 elderly patients with intertrochanteric fracture of femur treated in Department of Orthopedic of the hospital from June 2018 to June 2020 were selected as the study object.A total of 46 patients with pneumonia after surgery were included in the pneumonia group,and 724 patients without any other infections were included in the control group.Analyzed the correlation between white blood cell count(WBC),erythrocyte immune indicators[erythrocyte complement receptor 1 rosette rate(ECR1-RR),erythrocyte complement receptor 1 geometric mean fluorescence intensity(ECR1-GMFI)]and the occurrence of postoperative pneumonia.Analyzed the risk factors for postoperative pneumonia.Analyzed the diagnostic value of ECR1-GMFI,WBC alone and combined detection for the occurrence of postoperative pneumonia.Results The level of WBC was positively correlated with the occurrence of postoperative pneumonia(r=0.550,P<0.05),the levels of ECR1-RR and ECR1-GMFI were negatively correlated with the occurrence of postoperative pneumonia(r=-0.289,-0.313,P<0.05).Age>80 years old,smoking,WBC>10×10^(9)/L,anemia,reduced standardized ECR1-GMFI level,ASA grade≥gradeⅢ,operation time≥60 min were independent risk factors for the occurrence of postoperative pneumonia in patients(P<0.05).The area under the curve of ECR1-GMFI combined with WBC in the diagnosis of postoperative pneumonia was 0.984,the sensitivity was 96.32%,and the specificity was 91.57%,which were higher than those of the two indicators alone.Conclusion ECR1-GMFI is an independent risk factor for the occurrence of postoperative pneumonia in elderly patients with intertrochanteric fracture of femur,and combining it with WBC can also improve the diagnostic efficacy of postoperative pneumonia in patients.

关 键 词：股骨粗隆间骨折 肺炎 红细胞补体受体1花环率 红细胞补体受体1几何平均荧光强度 

分 类 号：R446.11+3[医药卫生—诊断学]