PD-1、sTREM-1及NLR在创伤性胫骨平台骨折术后感染中的预测价值

The value of PD⁃1,sTREM⁃1 and NLR in predicting postoperative infection of patients with traumatic tibial plateau fractures

目的探讨程序性死亡因子1(PD-1)、可溶性髓系细胞触发受体-1(sTREM-1)及中性粒细胞淋巴细胞比值(NLR)在创伤性胫骨平台骨折术后感染中的预测价值。方法选取2018年11月至2020年11月于本院手术的82例创伤性胫骨平台骨折患者,根据术后是否并发感染分为感染组(n=17)和未感染组(n=65)。比较两组PD-1、sTREM-1及NLR表达水平,分析影响创伤性胫骨平台骨折患者术后感染的危险因素。结果感染组PD-1、sTREM-1及NLR表达水平均高于未感染组,差异有统计学意义(P<0.05)。骨折类型、糖尿病、手术时间、骨筋膜室综合征、PD-1、sTREM-1及NLR表达水平是影响创伤性胫骨平台骨折患者术后感染的单因素(P<0.05)。Logistic回归多因素模型分析显示:开放性骨折、有糖尿病、手术时间>3 h、骨筋膜室综合征、PD-1、sTREM-1和NLR水平升高为影响创伤性胫骨平台骨折患者术后感染的危险因素(P<0.05)。结论 PD-1、sTREM-1及NLR水平在发生术后感染的创伤性胫骨平台骨折患者中异常升高,通过检测上述指标水平可评估患者术后感染风险。

Objective To explore the value of Mouse Programmed Death 1(PD⁃1),Soluble trig⁃gering receptor of myeloid cells(sTREM⁃1),and Neutrophil to Lymphocyte Ratio(NLR)in predicting postop⁃erative infection of patients with traumatic tibial plateau fractures.Methods The 82 patients with traumatic tibi⁃al plateau fractures who had surgical treatment in this hospital from November 2018 to November 2020 were se⁃lected.According to whether they had complicated infection after surgery,they were divided into an infected group(n=17)and an non⁃infected group(n=65).The expression levels of PD⁃1,sTREM⁃1 and NLR were com⁃pared between the two groups.The risk factors affecting postoperative infection in patients with traumatic tibial plateau fractures were analyzed.Results The expression levels of PD⁃1,sTREM⁃1 and NLR in the infected group were higher than those in the non⁃infected group,and the difference was statistically significant(P<0.05).Fracture type,diabetes,operation time,compartment syndrome,PD⁃1,sTREM⁃1 and NLR expression levels are the single factors affecting postoperative infection in patients with traumatic tibial plateau fractures(P<0.05).Logistic regression multivariate model analysis showed that open fractures,diabetes,operation time>3 h,compartment syndrome,the increasing of PD⁃1,sTREM⁃1 and NLR levels were the risk factors af⁃fecting postoperative infection in patients with traumatic tibial plateau fractures(P<0.05).Conclusion The levels of PD⁃1,sTREM⁃1,and NLR are abnormally increased in patients with traumatic tibial plateau fractures who have postoperative infection. The risk of postoperative infection can be assessed by detecting the levels of the above indicators.