血清ESR、CRP及溶菌酶活性检测对骨折患者骨感染的诊断价值

Diagnostic value of serum ESR,CRP and lysozyme activity detection for bone infection in patients with fracture

目的探讨血清红细胞沉降率(ESR)、C-反应蛋白(CRP)水平及溶菌酶活性对骨折患者骨感染的诊断价值。方法选择2017年3月至2020年12月在该院进行治疗的四肢骨折骨感染患者120例作为观察组,另选取同期在本院进行治疗的四肢骨折骨未感染患者120例作为对照组,比较两组患者的ESR、CRP水平及溶菌酶活性。应用受试者工作特征(ROC)曲线分析ESR、CRP水平及溶菌酶活性对骨折患者骨感染的诊断价值。结果观察组患者的ESR、CRP水平及溶菌酶活性[(56.65±1.65)mm/h、(81.68±2.04)mg/L、(1405.39±252.99)IU/L]均高于对照组[(25.30±2.22)mm/h、(6.45±2.75)mg/L、(1300.53±211.95)IU/L],两组比较差异有统计学意义(P<0.05);不同严重程度患者的ESR、CRP水平及溶菌酶活性比较,差异有统计学意义(P<0.05)。血清ESR、CRP水平及溶菌酶活性联合诊断对骨折患者骨感染的诊断特异度明显高于单一指标检测(P<0.05);血清ESR、CRP水平及溶菌酶活性的截断值分别为50.26 mm/h,75.26 mg/L,1350.26 IU/L,ROC曲线下面积(AUC)分别为0.775(95%CI:0.520~0.872)、0.603(95%CI:0.600~0.746)、0.622(95%CI:0.230~0.774),联合诊断的AUC为0.823(95%CI:0.126~0.996)。结论血清ESR、CRP水平及溶菌酶活性检测对骨折患者骨感染具有明显的预测效能,可作为骨折患者骨感染诊断的重要参考指标。

Objective To investigate the diagnostic value of serum erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and lysozyme activity for bone infection in the patients with fracture.Methods One hundred and twenty patients with limb fracture infection treated in this hospital from March 2017 to December 2020 were selected as the observation group,and other 120 patients with limb fracture non-infection treated in this hospital during the same period were selected as the control group.The levels of ESR,CRP and lysozyme activities were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of ESR,CRP and lysozyme activity for bone infection in fracture patients.Results The ESR and CRP levels and lysozyme activity in the observation group were(56.65±1.65)mm/h,(81.68±2.04)mg/L and(1405.39±252.99)IU/L respectively,which were significantly higher than(25.30±2.22)mm/h,(6.45±2.75)mg/L and(1300.53±211.95)IU/L in the control group,and the differences were statistically significant(P<0.05).The differences of ESR,CRP and lysozyme activity among the patients with different severities were statistically significant(P<0.05).The specificity of combined detection of serum ESR,CRP and lysozyme activity in diagnosing bone infection of fracture patients was significantly higher than that of single indicator detection(P<0.05).The cut-off values of serum ESR,CRP and lysozyme activities were 50.26 mm/h,75.26 mg/L and 1350.26 IU/L respectively.The area under the curve(AUC)was 0.775(95%CI:0.520-0.872),0.603(95%CI:0.600-0.746),and 0.622(95%CI:0.230-0.774),respectively,which of the combined diagnosis was 0.823(95%CI:0.126-0.996).Conclusion The detection of serum ESR,CRP and lysozyme activity has the significant predictive effect on bone infection in the patients with fracture,which could be used as the important reference indicators for bone infection in the patients with fracture.