血清NLR和SII与绝经后骨质疏松椎体压缩骨折的相关性及对短期预后的预测价值

Association of serum NLR and SII with postmenopausal osteoporotic vertebral compression fractures and their predictive value for short-term prognosis

目的探讨血清中性粒细胞/淋巴细胞比率(neutrophil-to-lymphocyte ratio,NLR)、全身免疫炎症指数(systemic immune-inflammation index,SII)水平与绝经后骨质疏松椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的相关性及对短期预后价值的分析。方法选取2018年12月至2021年12月吉林大学中日联谊医院收治的132例绝经后OVCF患者为观察组,98例绝经后骨质疏松但未患OVCF患者为对照组,对两组患者的一般资料、骨密度、NLR和SII进行分析比较,应用Logistic分析影响绝经后OVCF发生的相关因素。根据绝经后OVCF术后骨折再发情况分为两组,对NLR和SII绘制ROC曲线,分析其对绝经后骨质疏松OVCF的预后价值。结果对照组NLR为2.96±0.41、STI为39.41±23.45,观察组NLR水平为3.42±0.32、SII为431.77±31.14,与对照组相比水平均升高(P<0.05)。多因素Logistic回归分析显示腰椎骨密度(OR=0.030,95%CI:0.001~0.832,P=0.042)、NLR水平(OR=29.43,95%CI:9.840~103.6,P=0.001)和SII水平(OR=1.048,95%CI:1.034~1.066,P=0.001)均是影响绝经后OVCF的危险因素。再发骨折组NLR为3.77±0.22、SII为441.32±29.68,未再发骨折组的NLR为3.27±0.22、SII为426.87±30.57,差异有统计学意义(均P<0.05)。多因素Logistic回归分析显示腰椎骨密度(OR=8.56×10^(4),95%CI:3.884~2.992×10^(10),P=0.045)、NLR水平(OR=1.243×10^(-8),95%CI:2.911×10^(-13)~1.072×10^(-5),P=0.001)和SII水平(OR=0.938,95%CI:0.885~0.976,P=0.008)均是影响绝经后OVCF术后治疗效果的影响因素。ROC结果显示,血清NLR水平(AUC=0.86,95%CI:0.77~0.94,P<0.001)和SII水平(AUC=0.76,95%CI:0.67~0.85,P<0.001)均对绝经后OVCF进行术后疗效有较好的预测价值。结论NLR和SII是影响OVCF的危险因素,且有较好的短期预后价值。

Objective To explore the correlation between serum NLR and SII levels and postmenopausal osteoporotic vertebral compression fracture(OVCF)and to analyze the short-term prognostic value.Methods A total of 132 patients with postmenopausal OVCF admitted to our hospital from Dec.2018 to Dec.2021 were selected as the study group,and 98 patients with postmenopausal osteoporosis but did not suffer from OVCF were selected as the control group.According to the recurrence of postmenopausal OVCF fractures,the ROC curves of NLR and SII were plotted,and their prognostic value for postmenopausal osteoporosis OVCF was analyzed.Results NLR level was 2.96±0.41 and STI level was 39.41±23.45 in the control group.The level of NLR was 3.42±0.32 and SII was 431.77±31.14 in the research group(P<0.05).Multivariate Logistic regression analysis showed that lumbar bone density(OR=0.030,95%CI:0.001-0.832,P=0.042),NLR level(OR=29.43,95%CI:9.840-103.6,P=0.001)and SII level(OR=1.048,95%CI:1.034-1.066,P=0.001)were all risk factors affecting postmenopausal OVCF.NLR(3.77±0.22)and SII(441.32±29.68)in the recurrent fracture group were higher than NLR(3.27±0.22)and SII(426.87±30.57)in the non-recurrent fracture group,and the differences were statistically significant(all P<0.05),multivariate Logistic regression analysis showed lumbar spine bone density(OR=8.56×10^(4),95%CI:3.884-2.992×10^(10),P=0.045),NLR level(OR=1.243×10^(-8),95%CI:2.911×10^(-13)-1.072×10^(-5),P=0.001)and SII level(OR=0.938,95%CI:0.885-0.976,P=0.008)were all influencing factors affecting the postoperative treatment effect of postmenopausal OVCF,and ROC results showed that both NLR(AUC=0.86,95%CI:0.77-0.94,P<0.001)and SII(AUC=0.76,95%CI:0.67-0.85,P<0.001)had good prognostic value for postmenopausal OVCF.Conclusion NLR and SII are risk factors for OVCF in postmenopausal osteoporosis patients,and have good short-term prognostic value.