系统性炎症指标与老年骨质疏松症患者骨折发生的相关性  

Correlation of systemic inflammatory markers and fracture occurrence in elderly patients with osteoporosis

作　　者：宋云霄[1] 童巍 张海晨[1] 张银网[3] 卞晓波 张琳琳 袁文华[1] 赵智赟[1] 葛雯[1] 姚天悦 SONG Yunxiao;TONG Wei;ZHANG Haichen;ZHANG Yinwang;BIAN Xiaobo;ZHANG Linlin;YUAN Wenhua;ZHAO Zhiyun;GE Wen;YAO Tianyue(Department of Clinical Laboratory,Shanghai Xuhui Central Hospital,Shanghai 200031,China;Department of Clinical Laboratory,Shanghai Huangpu Mental Health Center,Shanghai 200122,China;Department of Orthopedics,Shanghai Xuhui Central Hospital,Shanghai 200031,China)

机构地区：[1]上海市徐汇区中心医院检验科,上海200031 [2]上海市黄浦区精神卫生中心检验科,上海200122 [3]上海市徐汇区中心医院骨科,上海200031

出　　处：《检验医学》2022年第3期235-239,共5页Laboratory Medicine

摘　　要：目的探讨系统性炎症指标[全身免疫炎症指数(SII)、血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)和C反应蛋白(CRP)]与老年骨质疏松症患者骨折发生的相关性。方法选取老年骨折患者249例(骨折组,其中创伤性骨折108例、脆性骨折141例)、老年骨质疏松症患者177例(骨质疏松症组)。检测所有患者血小板、淋巴细胞、单核细胞、中性粒细胞和CRP水平,计算SII、PLR、NLR和LMR。采用二分类Logistic回归分析评估老年骨质疏松症患者发生脆性骨折的危险因素。采用受试者工作特征(ROC)曲线分析各项指标单独和联合检测鉴别脆性骨折与创伤性骨折的效能。结果骨折组SII、PLR、NLR和CRP水平均显著高于骨质疏松症组(P<0.001),LMR水平显著低于骨质疏松症组(P<0.001)。ROC曲线分析结果显示,CRP、SII、PLR、NLR、LMR、CRP和5项指标联合检测鉴别脆性骨折和创伤性骨折的曲线下面积分别为0.589、0.899、0.835、0.866、0.788和0.903。多因素二分类Logistic回归分析显示,二分类Logistic回归分析结果显示,SII升高、PLR升高、NLR升高、CRP升高、LMR降低是老年骨质疏松症患者发生脆性骨折的危险因素[比值比(OR)值分别为1.001、1.008、1.178、1.021、0.813,95%可信区间(CI)分别为1.000~1.001、1.005~1.011、1.084~1.279、1.013~1.028、0.744~0.888]。结论SII、PLR、NLR、LMR和CRP均与老年骨质疏松症患者发生脆性骨折有关。Objective To investigate the correlations between systemic immune-inflammation index(SII),platelet/lymphocyte ratio(PLR),neutrophil/lymphocyte ratio(NLR),lymphocyte/monocyte ratio(LMR)and C-reactive protein(CRP)and fracture in elderly patients with osteoporosis.Methods Totally,249 elderly patients with fracture(fracture group,including 108 cases of traumatic fracture and 141 cases of brittle fracture)and 177 elderly patients with osteoporosis(osteoporosis group)were enrolled.Platelet,lymphocyte,monocyte,neutrophil and CRP levels were determined,and SII,PLR,NLR and LMR were calculated.The risk factors for fracture in elderly patients with osteoporosis were assessed by binary Logistic regression analysis.Receiver operating characteristic(ROC)curves were used to analyze the value of each indicator for the diagnosis of brittle fracture and traumatic fracture alone and in combination.Results The levels of SII,PLR,NLR and CRP in fracture group were higher than those in osteoporosis group(P<0.001),LMR levels were lower than those in osteoporosis group(P<0.001).ROC curve analysis showed that CRP,SII,PLR,NLR,LMR,CRP determinations and combined determination were 0.589,0.899,0.835,0.866,0.788 and 0.903,respectively,for distinguishing brittle fracture from traumatic fracture.The results of binary Logistic regression analysis showed that increased SII,PLR,NLR and CRP and decreased LMR were risk factors for brittle fracture in elderly patients with osteoporosis[odds ratios(OR)were 1.001,1.008,1.178,1.021 and 0.813,95%confidence intervals(CI)were 1.000-1.001,1.005-1.011,1.084-1.279,1.013-1.028,0.744-0.888,respectively].Conclusions SII,PLR,NLR,LMR and CRP are related to fracture occurrence in elderly patients with osteoporosis.

关 键 词：全身免疫炎症指数 血小板/淋巴细胞比值 中性粒细胞/淋巴细胞比值 淋巴细胞/单核细胞比值 C反应蛋白 骨折 骨质疏松症 

分 类 号：R446.1[医药卫生—诊断学]