目的: 探讨血清C-反应蛋白（C-reactive protein,CRP）、红细胞沉降率（erythrocyte sedimentation rate,ESR）及白细胞介素（interleukin,IL）-6在胫骨开放性骨折术后感染中的诊断价值。方法: 回顾性分析2020年4月至2024年4月本院收治的98例胫骨开放性骨折术后感染患者的临床资料。同期选取未发生感染的98例开放性胫骨骨折术后患者为对照组。检测两组患者术后第1天的血清CRP、ESR及IL-6水平。采用多因素Logistic回归分析术后感染的相关影响因素,并利用受试者工作特征（receiver operating characteristic,ROC）曲线评估CRP、ESR及IL-6在开放性胫骨骨折术后感染诊断中的效能。结果: 术后第1天感染组CRP、ESR及IL-6水平显著高于对照组（P<0.05）。Logistic多因素回归分析显示,血清CRP（OR=1.089,95%CI：1.035~1.146）、ESR（OR=1.063,95%CI：1.026~1.101）、IL-6（OR=1.145,95%CI：1.069~1.226）与胫骨开放性骨折患者术后感染发生密切相关（P<0.05）。ROC曲线分析结果,血清CRP、ESR及IL-6诊断胫骨开放性骨折术后感染的AUC分别为0.786、0.813、0.784,敏感度分别为0.806、0.652、0.857,特异性分别为0.643、0.857、0.561（P<0.05）。而三者血清指标联合诊断术后感染的AUC为0.913,敏感度为0.745,特异性为0.969（P<0.05）。结论: 血清CRP、ESR及IL-6联合检测能够显著提升诊断胫骨开放性骨折术后感染的准确性。
Abstract
Objective To investigate the diagnostic value of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and interleukin-6 (IL-6) on postoperative infection of open tibial fracture. Methods The clinical data of 98 patients with infection after open tibial fracture surgery in the hospital from April 2020 to April 2024 were retrospectively analyzed.98 patients without infection after open tibial fracture surgery were selected as the control group. The levels of serum CRP, ESR and IL-6 of the two groups of patients on the first day after the operation were detected. . Multivariate Logistic regression analysis was adopted to explore the related influencing factors of postoperative infection, and receiver operating characteristic (ROC) curve was applied to evaluate the efficiency of CRP, ESR and IL-6 in diagnosing postoperative infection of open tibial fracture. Results On the first day after the operation, the levels of CRP, ESR and IL-6 in the infection group were significantly higher than those in the control group (P<0.05). Logistic multivariate regression analysis showed that serum CRP (OR=1.089, 95%CI: 1.035-1.146), ESR (OR=1.063, 95%CI: 1.026-1.101), and IL-6 (OR=1.145, 95%CI: 1.069-1.226) was closely related to the occurrence of postoperative infection in patients with open tibial fractures (P<0.05) ROC curve analysis results showed that the AUCs of serum CRP, ESR and IL-6 in the diagnosis of infection after open tibial fracture surgery were 0.786, 0.813 and 0.784, the sensitivities were 0.806, 0.652 and 0.857, and the specificities were 0.643, 0.857 and 0.561 respectively (P<0.05). The AUC of combination of three serum indicators was 0.913, with sensitivity of 0.745 and specificity of 0.969 (P<0.05). Conclusion The combined detection of serum CRP, ESR and IL-6 can significantly improve the accuracy in the diagnosis of infection after open tibial fracture surgery.
关键词
胫骨开放性骨折 /
C-反应蛋白 /
红细胞沉降率 /
白细胞介素-6 /
诊断价值
Key words
open tibial fracture /
C-reactive protein /
erythrocyte sedimentation rate /
interleukin-6 /
diagnostic value
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基金
四川省中医药管理局课题“柏藤洗液促进慢性化脓性骨髓炎难愈性创面修复的临床研究”（2018LC027）; 成都中医药大学课题“柏藤洗液对大鼠慢性难愈合创面修复及组织病理学影响的实验研究”（YYZX2019017）
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