CD64指数、NLR及CRP/Alb比值诊断开放性骨折患者术后早期感染的价值

Diagnostic value of CD64 index, NLR and CRP/Alb ratio in early infection after open fracture surgery

目的探讨中性粒细胞指数(CD64指数)、中性粒细胞与淋巴细胞比值(NLR)及C反应蛋白/白蛋白(CRP/Alb)比值对开放性骨折患者术后早期感染的诊断价值。方法选自河南省洛阳正骨医院(河南省骨科医院)于2018年5月至2019年5月收治的开放性骨折患者93例,根据术后是否发生早期感染分为感染组37例与未感染组56例。采用流式细胞仪测定CD64指数;采用全自动血细胞分析仪测定NLR;采用免疫比浊法测定CRP含量,采用酶联免疫吸附试验(ELISA)测定Alb含量,计算CRP/Alb。比较两组CD64指数、NLR、CRP/Alb比值变化及联合诊断灵敏度和特异度。结果开放性骨折患者93例中,发生术后早期感染37例,感染率为39.78%;感染组CD64指数、NLR及CRP/Alb比值显著高于未感染组,差异具有统计学意义(P<0.05);CD64指数、NLR及CRP/Alb比值联合诊断特异度和灵敏度高于各单项指标检测。结论CD64指数、NLR及CRP/Alb比值对开放性骨折患者术后早期感染中具有重要价值,联合诊断可提高灵敏度和特异度,值得临床借鉴。

Objective To investigate the diagnostic value of neutrophil index (CD64 index),neutrophil to lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CRP/Alb) in early infection after open fracture surgery. Methods The 93 patients with open fracture were divided into infected group (37 cases) and uninfected group (56 cases) according to whether early infection occurred after operation.CD64 index was measured by flow cytometry,NLR was measured by automatic blood cell analyzer,CRP was determined by immunoturbidimetry,Alb was determined by ELISA,and CRP/Alb was calculated.The changes of CD64 index,NLR and CRP/Alb ratio,as well as the sensitivity and specificity of combined diagnosis were compared between the two groups. Results Among 93 cases of open fracture,37 cases had early infection after operation,the infection rate was 39.78%.The CD64 index,NLR and CRP/Alb ratio in infection group were higher than those in non-infection group ( P <0.05);the specificity and sensitivity of CD64 index,NLR and CRP/Alb ratio in combined diagnosis were higher than those of single index detection. Conclusions CD64 index,NLR and CRP/Alb ratio are of great value in the early infection of open fracture patients.Combined diagnosis can improve the sensitivity and specificity,which is worthy of clinical reference.