老年多发创伤骨折患者ChE、CRP/ALB比值检测对术后早期感染的预测作用

Prediction of ChE,CRP/ALB ratio detection for early postoperative infection in elderly patients with multiple traumatic fractures

目的 研究老年多发创伤骨折患者胆碱酯酶(ChE)、C反应蛋白/白蛋白(CRP/ALB)比值检测对术后早期感染的预测作用。方法 选取东方市东方医院2019年3月至2020年9月收治的94例老年多发创伤骨折的临床资料,按照患者术后是否发生早期感染分为23例感染组与71例非感染组,另外收集81名同期老年体检健康者纳入对照组。用比色法检测血清ChE浓度;用免疫比浊法检测血清CRP浓度;用溴甲酚绿法检测血清ALB浓度。结果 与对照组比较,多发创伤骨折组术前、术后第1 d、第3 d、第5 d时ChE水平较低,而CRP/ALB高,差异有统计学意义(P<0.05)。术前、术后第1 d、第2 d、第5 d时,术后早期感染组ChE均低于术后无早期感染组,差异有统计学意义(P<0.05)。术前、术后第1 d、第2 d、第5 d时,术后早期感染组CRP/ALB均高于术后无早期感染组,差异有统计学意义(P<0.05)。与确诊时比较,治疗后第3 d和第5 d时术后早期感染患者ChE水平较高,而CRP/ALB较低,差异有统计学意义(P<0.05)。结论 老年多发创伤术后早期感染患者ChE浓度持续下降,CRP/ALB比值显著上升,可作为术后早期感染的有效预测指标,并可指导抗感染治疗。

Objective To study the predictive effect of cholinesterase(ChE)and C-reactive protein/albumin(CRP/ALB)ratio detection for early postoperative infection in elderly patients with multiple trauma fractures. Methods The clinical data of 94 elderly patients with multiple trauma fractures admitted to Dongfang Dongfang Hospital from March 2019 to September 2020 were retrospectively analyzed. According to whether the patients had early infection after surgery,they were divided into 23 cases of infection group and 71cases of non-infection group. A total of 81 healthy elderly people with physical examination during the same period were collected and included in the control group. Serum ChE concentration was detected by colorimetric method;serum CRP concentration was detected by immunoturbidimetric method;serum ALB concentration was detected by bromocresol green method. Results Compared with the control group,the levels of ChE in the multiple trauma fracture group were lower before operation,1 d,3 d,and 5 d after operation,but CRP/ALB was higher,and the difference was statistically significant(P<0.05). Before operation,on the 1st,2nd,and 5th day after operation,the ChE in the early postoperative infection group was lower than that in the no early postoperative infection group,and the difference was statistically significant(P<0.05). Before operation,on the 1st,2nd,and 5th day after operation,the CRP/ALB in the early postoperative infection group was higher than that in the no early postoperative infection group,and the difference was statistically significant(P<0.05). Compared with the time of diagnosis,the levels of ChE in patients with early postoperative infection were higher on the 3rd and 5th day after treatment,but the CRP/ALB was lower,and the difference was statistically significant(P<0.05). Conclusion The concentration of ChE decreased continuously and the ratio of CRP/ALB increased significantly in elderly patients with multiple trauma postoperative early infection,which can be used as an effective predictor of early postoperative infection and guide anti-infective treatment.