骨关节置换术后早期感染中NLR和CRP的预测价值

Predictive Value of NLR and CRP in Early Infection after Bone and Joint Replacement

目的探讨骨关节置换术后早期感染中NLR和CRP的预测价值。方法回顾性选取2019年2月—2021年2月该院骨关节置换术患者200例,依据术后早期感染发生情况分为感染组与未感染组。感染组30例,未感染组170例,感染率为15.0%,统计分析两组患者术后第1、3天,第1周的NLR和CRP水平,分析感染组患者的NLR和CRP的预测价值。结果两组患者术后第1、3天,第1周的NLR均逐渐降低,差异有统计学意义(P<0.05);术后第3天的CRP水平均高于术后第1天、第1周,差异有统计学意义(P<0.05);术后第1天的CPR水平均高于术后1周,差异有统计学意义(P<0.05)。术后第1、3天两组患者的NLR和CRP水平之间的差异无统计学意义(P>0.05);术后1周,感染组患者的NLR和CRP水平均高于未感染组,差异有统计学意义(P<0.05)。术后1周NLR的临界值、敏感性、特异性分别为2.88、93.6%、45.7%;CRP的临界值、敏感性、特异性分别为45.6 mg/L、50.0%、77.8%;NLR>2.88、CRP>45.6 mg/L时NLR+CRP的敏感性、特异性分别为95.2%、52.4%。NLR+CRP、NLR的敏感性均高于CRP,差异有统计学意义(P<0.05);特异性均低于CRP,差异有统计学意义(P<0.05);NLR+CRP的特异性高于NLR,差异有统计学意义(P<0.05),但两者的敏感性之间差异无统计学意义(P>0.05)。结论骨关节置换术后早期感染中NLR和CRP联合检测的预测价值较单独检测高。

Objective To explore the predictive value of NLR and CRP in early infection after bone and joint replacement.Methods A retrospective selection of 200 patients undergoing bone and joint replacement in the hospital from February 2019 to February 2021 were selected.According to the incidence of early postoperative infection,they were divided into infected group and non-infected group.There were 30 cases in the infected group and 170 cases in the uninfected group.The infection rate was 15.0%.The NLR and CRP levels of the two groups of patients on the 1st,3rd,and 1 week after the operation were statistically analyzed,and the predictive value of the NLR and CRP of the patients in the infection group was analyzed.Results The NLR of the two groups of patients decreased gradually on the 1st,3rd,and 1st week after operation,the difference was statistically significant(P<0.05).The CRP level on the 3rd day after operation was higher than that on the 1st day and 1 week after operation,the difference was statistically significant(P<0.05).The CPR level on the first day after surgery was higher than that at the first week after surgery,the difference was statistically significant(P<0.05).The difference in NLR and CRP levels between the two groups of patients on the 1st and 3rd day after surgery was not statistically significant(P>0.05).At 1 week after surgery,the levels of NLR and CRP in the infected group were higher than those in the uninfected group,the difference was statistically significant(P<0.05).The cut-off value,sensitivity,and specificity of NLR at 1 week after surgery were 2.88,93.6%,and 45.7%,respectively.The cut-off value,sensitivity,and specificity of CRP were 45.6 mg/L,50.0%,and 77.8%,respectively.When NLR>2.88 and CRP>45.6 mg/L,the sensitivity and specificity of NLR+CRP were 95.2%and 52.4%,respectively.The sensitivity of NLR+CRP and NLR were higher than CRP,the difference was statistically significant(P<0.05).The specificity was lower than that of CRP,the difference was statistically significant(P<0.05),and the specificity of NLR+CRP was higher than that of NLR,the difference was statistically significant(P<0.05),but the difference in sensitivity between the two was not statistically significant(P>0.05).Conclusion The predictive value of combined detection of NLR and CRP in early infection after bone and joint replacement is higher than that of detection alone.