老年骨科患者术后感染病原菌及血清SIRI、SII与NLR的预测价值  

Pathogens of postoperative infection in elderly orthopedic patients and the predictive value of serum SIRI,SII and NLR

作　　者：何素瑞 张令博 王向朝 王俊召 张晓彤 HE Surui;ZHANG Lingbo;WANG Xiangchao;WANG Junzhao;ZHANG Xiaotong(Medical Laboratory Department of Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei,China,054000)

机构地区：[1]华北医疗健康集团邢台总医院医学检验科,河北邢台054000

出　　处：《分子诊断与治疗杂志》2025年第2期342-345,349,共5页Journal of Molecular Diagnostics and Therapy

基　　金：邢台市科技计划项目(2017ZC051)。

摘　　要：目的分析老年骨科患者术后感染病原菌分布情况及血清SIRI、SII、NLR的预测价值。方法回顾性选取华北医疗健康集团邢台总医院2021年9月至2023年9月收治的93例老年骨科术后感染患者为感染组(n=93),另选同期94例术后无感染的老年骨科患者为非感染组(n=94)。分析感染组患者的病原菌特征;检测两组血清SIRI、SII、NLR表达;分析老年骨科患者术后感染的影响因素;绘制ROC曲线分析血清SIRI、SII、NLR表达对老年骨科患者术后发生感染的预测价值。结果感染组患者共检出病原菌96株,其中革兰阴性菌株80株(83.33%),革兰阳性菌16株(16.67%)。感染组血清SIRI、SII、NLR表达均高于非感染组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,住院时间>10 d、留置导尿管、有糖尿病史血清SIRI高表达、SII高表达及NLR高表达均是老年骨科患者术后感染的独立危险因素(P<0.05);ROC曲线分析显示,血清SIRI、SII、NLR表达及联合检测的曲线下面积(AUC)分别为0.958、0.938、0.938、0.965,联合检测优于单一检测(P<0.05)。结论老年骨科患者术后感染病原菌种类较多,以革兰阴性菌为主;血清SIRI、SII、NLR表达与老年骨科患者术后感染相关。Objective To analyze the distribution of pathogens and the predictive value of SIRI,SII,and NLR in elderly orthopedic patients after surgery.Methods 93 elderly patients with postoperative orthopaedic infection admitted to Xingtai General Hospital of North China Medical and Health Group from September 2021 to September 2023 were retrospectively selected as the infection group(n=93),and 94 elderly orthopaedic patients without postoperative infection during the same period were selected as the non-infected group(n=94).The characteristics of pathogenic bacteria in the infection group were analyzed.The expression of SIRI,SII,and NLR in serum of two groups were detected.To analyze the influencing factors of postoperative infection in elderly orthopedic patients,a ROC curve was drawn to analyze the predictive value of serum SIRI,SII,and NLR expression on postoperative infection in elderly orthopaedic patients.Results A total of 96 pathogenic bacteria were detected in the infection group,including 80 gram-negative strains(83.33%).There were 16 gram-positive strains(16.67%).The expressions of SIRI,SII,and NLR in the infected group were higher than those in the non-infected group(P<0.05).Multivariate logistic regression analysis showed that length of stay>10 days,indurating catheter,history of diabetes,high expression of serum SIRI,high expression of SII and high expression of NLR were the only cases of postoperative infection in elderly orthopedic patients Risk factors(P<0.05).ROC curve analysis showed that the expression of SIRI,SII,and NLR in serum and the AUC of combined detection were 0.958,0.938,0.938 and 0.965,respectively.Combined detection was superior to single detection(P<0.05).Conclusion There are many pathogens that can cause postoperative infections in elderly orthopedic patients,with gram-negative bacteria being the main culprits.The levels of serum SIRI,SII,and NLR were found to be correlated with postoperative infections in elderly orthopedic patients.

关 键 词：骨科 感染 全身炎症反应指数 系统免疫炎症指数 中性粒细胞与淋巴细胞比值 

分 类 号：R73[医药卫生—肿瘤]