骨折患者血清NGAL、钙卫蛋白联合检测在骨关节置换术后早期感染中的应用价值

Application value of combined detection of serum NGAL and calprotectin in patients with fracture in early infection after joint replacement surgery

目的探讨骨折患者血清中性粒细胞明胶酶相关载脂蛋白(NGAL)、钙卫蛋白联合检测在骨关节置换术后早期感染中的应用价值。方法选取2021年7月至2022年7月在该院进行骨关节置换术的骨折患者206例作为研究对象,根据骨关节置换术后是否发生感染分为感染组(n=29)和未感染组(n=177)。酶联免疫吸附试验检测血清NGAL、钙卫蛋白水平,多因素Logistic回归分析骨折患者骨关节置换术后感染的影响因素。绘制受试者工作特征曲线分析血清NGAL、钙卫蛋白联合检测在骨折患者骨关节置换术后早期感染中的诊断效能。结果感染组合并糖尿病比例、红细胞沉降率(ESR)显著高于未感染组,而白蛋白显著低于未感染组,差异有统计学意义(P<0.05)。术后感染组血清NGAL、钙卫蛋白水平均显著高于术后未感染组,差异有统计学意义(P<0.05)。血清NGAL、钙卫蛋白、ESR、合并糖尿病是骨折患者骨关节置换术后早期感染的危险因素,而血清白蛋白是保护因素(P<0.05)。血清NGAL、钙卫蛋白、二者联合诊断骨折患者骨关节置换术后早期感染的曲线下面积分别为0.838、0.813、0.934,二者联合优于血清NGAL、钙卫蛋白各自单独诊断(Z=2.720、2.357,P=0.007、0.018)。结论血清NGAL、钙卫蛋白联合检测对骨折患者骨关节置换术后早期感染的发生具有较优的诊断效能,对临床预后有一定应用价值。

Objective To explore the application value of combined detection of serum neutrophil gelatinase-associated lipocalin(NGAL)and calprotectin in patients with fracture in early infection after joint replacement surgery.Methods A total of 206 fracture patients who underwent joint replacement surgery in a hospital from July 2021 to July 2022 were selected as the study objects,and divided into infection group(n=29)and non-infection group(n=177)according to whether infection occurred after joint replacement surgery.Serum NGAL and calprotectin levels were detected by enzyme-linked immunosorbent assay,and the influencing factors of infection after joint replacement surgery in fracture patients were analyzed by multivariate Logistic regression.The receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of serum NGAL and calprotectin combined detection in early infection after joint replacement surgery in fracture patients.Results The proportion of diabetes mellitus and erythrocyte sedimentation rate(ESR)in infection group were significantly higher than those in non-infection group,while albumin was significantly lower than that in non-infection group,with statistical significance(P<0.05).The levels of serum NGAL and calprotectin in postoperative infection group were significantly higher than those in postoperative non-infection group,with statistical significance(P<0.05).Serum NGAL,calprotectin,ESR and diabetes mellitus were risk factors for early infection after joint replacement surgery,while serum albumin was protective factor(P<0.05).The area under the curve for the diagnosis of early infection after joint replacement surgery in patients with fracture was 0.838,0.813 and 0.934,respectively,and the combination of serum NGAL,calprotectin,and both were superior to the diagnosis of serum NGAL and calprotectin alone(Z=2.720,2.357,P=0.007,0.018).Conclusion The combined detection of serum NGAL and calprotectin has better diagnostic efficacy for early infection after joint replacement surgery in fracture patients,and has certain application value for clinical prognosis.