血清PCT水平与NLR预测开放性骨折患者术后早期感染的价值分析  

Analysis of Serum PCT Level and NLR in Predicting Early Postoperative Infection in Patients with Open Fracture

作　　者：李树伟 赵幸熬 付晓宁 王军伟 LI Shuwei;ZHAO Xing’ao;FU Xiaoning;WANG Junwei(Department of Orthopedics,Dengfeng People’s Hospital,Dengfeng,Henan 452470,China)

机构地区：[1]登封市人民医院骨科,河南登封452470

出　　处：《中国烧伤创疡杂志》2025年第1期49-52,71,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的分析探讨血清降钙素原(PCT)水平、中性粒细胞与淋巴细胞比值(NLR)对开放性骨折患者术后早期感染的预测价值。方法选取2020年12月至2022年12月登封市人民医院收治的240例行手术治疗的开放性骨折患者作为研究对象,收集患者性别、年龄、体重指数、吸烟史、糖尿病病史、高血压病史以及血清PCT水平、NLR和术后感染情况等资料,并根据术后早期(术后7 d内)感染发生情况将其分为感染组与未感染组,采用多因素Logistic回归分析血清PCT水平和NLR与开放性骨折患者术后早期感染的相关性,采用受试者操作特征(ROC)曲线分析血清PCT水平和NLR对开放性骨折患者术后早期感染的预测价值。结果术后早期,240例开放性骨折患者出现感染32例(13.33%),设为感染组;未出现感染208例(86.67%),设为未感染组。术后第1天,感染组患者血清PCT水平和NLR均明显高于未感染组(t=28.793、20.174,P均<0.001)。多因素Logistic回归分析结果显示,年龄、糖尿病病史、血清PCT水平和NLR与开放性骨折患者术后早期感染密切相关,是其独立影响因素(95%CI为1.162~14.675、1.339~28.272、1.437~22.846、1.527~18.551,P=0.028、0.020、0.013、0.009)。ROC曲线分析结果显示,血清PCT水平与NLR联合预测开放性骨折患者术后早期感染的曲线下面积为0.968、灵敏度为89.5%、特异度为93.4%。结论血清PCT水平和NLR联合可有效预测开放性骨折患者术后早期感染的发生风险,具有较高的临床应用价值。Objective To analyze the predictive value of serum procalcitonin(PCT)levels and neutrophil to lymphocyte ratio(NLR)for early postoperative infection in patients with open fracture.Methods 240 patients with open fracture admitted into Dengfeng People's Hospital from December 2020 to December 2022 for surgical treatment were selected as research subjects to collect the data of patients including sex,age,body mass index,history of smoking,diabetes and hypertension,serum PCT level,NLR,and postoperative infection.The patients were divided into the infected group and the non-infected group according to the occurrence of infection during the early postoperative period(within 7 days after operation).Multivariate Logistic regression was conducted to analyze the correlation between serum PCT level and NLR and early postoperative infection in patients with open fracture.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum PCT level and NLR in early postoperative infection in patients with open fracture.Results During the early postoperative period,32 cases(13.33%)of 240 open fracture patients developed infection,being set as the infected group,and 208 cases(86.67%)did not develop infection,being set as the non-infected group.On day 1 after operation,the serum PCT level and NLR of patients in the infected group were significantly higher than those in the non-infected group(t=28.793 and 20.174,both P<0.001).The results of multivariate Logistic regression analysis showed that age,history of diabetes,serum PCT level and NLR were closely associated with the early postoperative infection of patients with open fracture and were independent risk factors(95%CI:1.162-14.675,1.339-28.272,1.437-22.846,1.527-18.551,P=0.028,0.020,0.013 and 0.009).ROC curve analysis showed that the area under the curve of the combination of serum PCT level and NLR to predict early postoperative infection in patients with open fracture was0.968,with the sensitivity being 89.5%and the specificity being 93.4%.Conclusi

关 键 词：开放性骨折 降钙素原 中性粒细胞与淋巴细胞比值 术后早期感染 预测价值 

分 类 号：R73[医药卫生—肿瘤]