炎症因子及sTREM-1水平对骨折患者术后感染的评估价值

Value of inflammatory factors and sTREM-1 levels in assessing postoperative infection in patients with fractures

目的观察骨折术后患者的炎症相关指标变化情况,探讨sTREM-1水平对骨折患者术后感染的评估价值。方法对比观察120例骨折手术治疗患者在术前1 d、术后1 d、术后7 d的Th细胞亚群、IL-6、IL-8、sTREM-1、TNF-α、CRP、PCT水平,统计患者术后感染情况,并比较是否感染患者间上述指标的差异。结果术后7 d,2组的Th1、Th1/Th_(2)均下降,患者的Th_(2)、IL-6、IL-8、TNF-α、sTREM-1、CRP水平显著上升,差异均有统计学意义(P<0.05)。术后共31例发生感染,感染患者术后7 d的Th1、Th1/Th_(2)低于非感染患者,Th_(2)、IL-6、IL-8、TNF-α、sTREM-1、CRP、PCT水平显著高于非感染者,差异均有统计学意义(P<0.05)。术前1 d,IL-6、IL-8、TNF-α、sTREM-1、CRP、PCT的术后感染曲线下面积(AUC)均<0.7;术后1 d、术后7 d,各指标的AUC值均增加,以sTREM-1的AUC值最高(AUC=0.951、0.924)。结论骨折术后感染患者的外周血炎症因子水平上升,对感染的早期判断提供参考依据,sTREM-1可作为骨折术后感染病情和病程评估的重要指标。

Objective To investigate the value of sTREM-1 levels in evaluating postoperative infection in patients with fractures by observing the changes of inflammation-related indicators.Methods The levels of Th cell subsets,IL-6,IL-8,sTREM-1,TNF-α,CRP and PCT were comparatively observed in 120 patients with fractures 1 d before,1 d after,and 7 d after surgery,so it was the postoperative infections.The differences in these indicators between patients with and without infection were also compared.Results At 7 d postoperatively,the levels of Th1,Th1/Th_(2) decreased significantly in the groups,and Th_(2),IL-6,IL-8,TNF-α,sTREM-1,and CRP levels increased significantly(P<0.05).A total of 31 postoperative infections occurred,and the Th1 and Th1/Th_(2) in infected patients were lower than those in non-infected patients at 7 d postoperatively,and the levels of Th_(2),IL-6,IL-8,TNF-α,sTREM-1,CRP,and PCT were significantly higher than those in non-infected patients(P<0.05).The area under the postoperative infection curve(AUC)of IL-6,IL-8,TNF-α,sTREM-1,CRP,and PCT were all<0.7 at one day before surgery.The AUC values of all indicators elevated at 1 d and 7 d postoperatively,with the highest AUC values for sTREM-1(AUC=0.951,0.924).Conclusions Increased levels of peripheral blood inflammatory factors in patients with post-fracture infection provide a reference for the early determination of infection.sTREM-1 can be a meaningful indicator for assessing the condition and course of infection after fracture surgery.