血常规、生化及血清白介素-6、肿瘤坏死因子-α对骨折患者内固定术后不良事件的预测价值分析  

Predictive Value Analysis of Blood Routine,Biochemical Indicators,Serum Interleukin-6,and Tumor Necrosis Factor-αfor Adverse Events After Internal Fixation Surgery in Fracture Patients

作　　者：闻静 WEN Jing(Department of Orthopedics,First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 472000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院骨科,河南南阳472000

出　　处：《临床研究》2025年第4期16-20,共5页Clinical Research

摘　　要：目的分析骨折患者血常规生化指标、血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)对预测其接受内固定术后不良反应的作用效果。方法回顾性收集2021年1月至2023年12月期间南阳医学高等专科学校第一附属医院收治的96例接受内固定术的骨折患者作为研究对象,收集患者的基本资料(包括人口学特征资料和临床基本资料),术后第3 d以及出院前1 d血常规指标、血生化指标和血清炎症因子检测结果,统计患者术后1年内的预后结局。结果纳入分析的患者中有29例患者出现预后不良(分为预后不良组),67例患者预后良好(分为预后良好组)。术后第3 d,预后不良组患者年龄、白细胞计数(WBC)、中性粒细胞计数(NEU)、C反应蛋白(CRP)、肌酐(Scr)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)结果均明显高于预后良好组,差异均有统计学意义(P<0.05);出院前1 d,预后不良患者的WBC、CRP、IL-6以及TNF-α显高于预后良好组患者,血红蛋白(Hb)低于预后良好组患者,差异均有统计学意义(P<0.05)。二元Logistic回归分析显示,术后第3 d的WBC、NEU、CRP、Scr、IL-6、TNF-α,以及出院前1 d的Hb、CRP、IL-6、TNF-α均是接受内固定术患者发生不良预后的影响因素,差异均有统计学意义(P<0.05)。术后第3 d的受试者工作特征(ROC)曲线分析显示NEU对患者不良预后的预测价值一般,IL-6对患者不良预后的预测价值较好,而WBC、CRP对患者的不良预后预测价值理想,差异均有统计学意义(P<0.05);出院前1 d的ROC曲线分析显示TNF-α和IL-6对患者不良预后的预测价值较好,而CRP对患者的不良预后预测价值理想,差异均有统计学意义(P<0.05)。结论接受内固定术的骨折患者的血常规、生化指标以及血清炎症指标与其不良预后密切相关,术后可综合运用多指标评估患者的不良预后风险并及时采取干预措施,降低不良事件的发生率,改善患者的预后结局。Objective To analyze the efficacy of blood routine biochemical indicators,serum interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in predicting adverse reactions after internal fixation surgery in fracture patients.Methods A retrospective collection of data from 96 fracture patients who underwent internal fixation surgery at the First Affiliated Hospital of Nanyang Medical College from January 2021 to December 2023 was conducted.Basic patient data—including demographic and clinical features—and results of blood routine indices,biochemical indicators,and serum inflammatory factor tests on the 3rd day post-surgery and one day before discharge were collected.Patients'prognostic outcomes within one year post-surgery were also documented.Results Among the analyzed patients,29 experienced poor prognosis(classified into the poor prognosis group)and 67 had a good prognosis(classified into the good prognosis group).On the 3rd day post-surgery,the poor prognosis group showed significantly higher levels of age,white blood cell count(WBC),neutrophil count(NEU),C-reactive protein(CRP),creatinine(Scr),IL-6,and TNF-αcompared to the good prognosis group,with all differences being statistically significant(P<0.05).One day before discharge,higher levels of WBC,CRP,IL-6,and TNF-αand lower levels of hemoglobin(Hb)were observed in the poor prognosis group compared to the good prognosis group,with statistically significant differences(P<0.05).Binary logistic regression analysis showed that age,WBC,NEU,CRP,Scr,IL-6,TNF-αon the 3rd day post-surgery,and Hb,CRP,IL-6,TNF-αone day before discharge were influential factors affecting adverse prognosis,with statistically significant differences(P<0.05).ROC curve analysis on the 3rd day post-surgery indicated that NEU had moderate predictive value,IL-6 had good predictive value,and WBC and CRP had ideal predictive value for adverse prognosis,with statistically significant differences(P<0.05).ROC curve analysis one day before discharge showed that TNF-αand IL-6 had good predictive

关 键 词：骨折内固定术 血常规 白介素-6 肿瘤坏死因子-Α 不良预后结局 

分 类 号：R274.1[医药卫生—中医骨伤科学]