NAP和SDF-1与sTREM-1对胫骨骨折术后感染的预测价值  

Predictive value of NAP,SDF-1 and sTREM-1 for postoperative infection in tibial fractures

作　　者：汤斌[1] 栾兆新 王志震[1] 陈光鑫[1] 刘子祯[1] 于博 TANG Bin;LUAN Zhao-xin;WANG Zhi-zhen;CHEN Guang-xin;LIU Zi-zhen;YU Bo(Liaocheng Second People's Hospital,Liaocheng,Shandong 252600,China)

机构地区：[1]聊城市第二人民医院手足显微外科,山东聊城252600

出　　处：《中华医院感染学杂志》2023年第19期2968-2972,共5页Chinese Journal of Nosocomiology

基　　金：聊城市科学技术发展计划基金资助项目(2020GZC3932)。

摘　　要：目的 探讨中性粒细胞碱性磷酸酶(NAP)、基质细胞衍生因子-1(SDF-1)、可溶性髓系细胞触发受体-1(sTREM-1)对胫骨骨折患者术后感染的预测价值.方法 选取2019年10月-2022年4月于聊城市第二人民医院就诊的胫骨骨折术后感染患者82例为研究组,同期术后未感染患者82例为对照组;检测术后当天、3 d、5 d NAP积分、SDF-1、sTREM-1与降钙素原(PCT)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,探究NAP积分、SDF-1、sTREM-1与炎症因子的关联性,及各时间点各指标与胫骨骨折患者术后感染的关系,并探讨NAP积分、SDF-1、sTREM-1对胫骨骨折患者术后感染的预测价值.结果 研究组术后5 d NAP积分、SDF-1、sTREM-1、PCT、CRP、TNF-α均高于对照组(P<0.05);胫骨骨折术后感染患者 NAP积分、SDF-1、sTREM-1与血清PCT、CRP、TNF-α水平呈正相关(P<0.05);Logistic逐步回归分析显示,术后5 d血NAP积分、SDF-1、sTREM-1、CRP、TNF-α是胫骨骨折患者术后感染的危险因素(P<0.05);术后5 d NAP积分、SDF-1、sTREM-1单独及联合检测早期诊断胫骨骨折患者术后感染的曲线下面结(AUC)分别为0.843、0.801、0.839优于其他感染指标.结论 胫骨骨折术后感染患者NAP、SDF-1、sTREM-1升高,尤以术后5 d升高最为显著,各指标单独及联合检测对胫骨骨折患者术后感染的诊断效能优于常规感染指标,具有较高的早期预测价值.OBJECTIVE To investigate the predictive value of blood neutrophil alkaline phosphatase(NAP),stromal cell derived factor-1(SDF-1),and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)for postoperative infection in patients with tibia fracture.METHODS Totally 82 patients with postoperative infection of tibial fractures in Liaocheng Second People's Hospital from Oct.2019 to Apr.2022 were selected as the study group,and 82 patients without postoperative infection during the same period were selected as the control group.The general data,blood NAP scores,SDF-1,sTREM-1 and procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)levels on the day after surgery were statistically compared between the two groups.The relationship between blood NAP scores,SDF-1,sTREM-1 and inflammatory factors,and the relationship between each indicator and postoperative infection in tibial fracture patients at each time point were investigated,and the predictive value of blood NAP scores,SDF-1 and sTREM-1 for postoperative infection in tibialfracture patients was also explored.RESULTS The blood NAP score,SDF-1,STREM-1,PCT,CRP and TNF-αlevels in the study group were higher than those in the control group on the day,3 d and 5 d after surgery(P<0.05).There was a positive correlation between NAP scores,SDF-1,sTREM-1,and serum PCT,CRP,and TNF-αlevels in postoperative infected patients with tibial fractures(P<0.05).Logistic stepwise regression analysis showed that blood NAP scores,SDF-1,sTREM-1,CRP,and TNF-αlevels at 5 days after surgery were risk factors for postoperative infection in patients with tibial fractures(P<0.05).Area under the curve(AUC)of NAP scores,SDF-1,and sTREM-1 alone and in combination for the early diagnosis of postoperative infection in patients with tibial fractures at 5 d postoperatively were 0.843,0.801 and 0.839,respectively,which were superior to the other infection indicators.CONCLUSION Blood NAP,SDF-1 and STREM-1 were elevated in patients with postoperative tibia fracture infectio

关 键 词：胫骨骨折 术后感染 中性粒细胞碱性磷酸酶 基质细胞衍生因子-1 可溶性髓系细胞触发受体-1 预测价值 

分 类 号：R619.3[医药卫生—外科学]