| 宋扬,高全有,钱澍,等.中性粒细胞与淋巴细胞比值、衍生的中性粒细胞与淋巴细胞比值、系统免疫炎症指数在微创经椎间孔腰椎椎间合术后手术部位感染预测中的应用[J].中国临床保健杂志,2022,25(6):828-832. |
| 中性粒细胞与淋巴细胞比值、衍生的中性粒细胞与淋巴细胞比值、系统免疫炎症指数在微创经椎间孔腰椎椎间合术后手术部位感染预测中的应用 |
| Predictive value of NLR,dNLR and SII for surgical site infection after minimally invasive transforaminal lumbar interbody fusion |
| 投稿时间：2022-11-14 |
| DOI：10.3969/J.issn.1672-6790.2022.06.024 |
| 中文关键词: 脊柱融合术 外科伤口感染 最小侵入性外科手术 危险因素 预测 |
| 英文关键词: Spinal fusion Surgical wound infection Minimally invasive surgical procedures Risk factors Forecasting 〖FL |
| 基金项目:国家自然科学基金项目(81871818) |
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| 中文摘要: |
| 目的 探讨中性粒细胞与淋巴细胞比值(NLR)、衍生的中性粒细胞与淋巴细胞比值(dNLR)以及系统免疫炎症指数(SII)在预测微创经椎间孔腰椎椎间融合术(MIS-TLIF)术后手术部位感染(SSI)的应用价值。方法 收集2019年5月至2022年5月空军军医大学唐都医院行MIS-TLIF手术治疗的198例腰椎退行性疾病患者的临床资料,将发生术后SSI的患者纳入SSI组,按1∶4比例选取未发生术后SSI的患者纳入非感染组。收集2组患者一般资料、血常规以及血生化检测结果,计算NLR、dNLR及SII,采用ROC曲线评价NLR、dNLR及SII对SSI的预测价值。结果 SSI组和非感染组患者的年龄、合并糖尿病比例、手术时间、术中出血量、血白蛋白(Alb)、白细胞(WBC)、超敏C反应蛋白(hs-CRP)水平比较,差异均有统计学意义(P<0.05)；SSI组患者的dNLR、MLR及SII水平均显著高于非感染组(P<0.05)；多因素logistic回归结果显示,高龄、合并糖尿病、手术时间长以及高hs-CRP、NLR、dNLR、SII水平是发生SSI的独立危险因素(P<0.05)；术后第1天的dNLR、NLR及SII三者联合预测SSI的AUC为0.903(95%CI:0.819~0.956),大于hs-CRP预测的AUC[0.836(95%CI:0.740~0.907),P<0.05]。结论 腰椎退行性疾病行MIS-TLIF手术发生SSI者术后第1天的NLR、dNLR及SII水平明显升高,三者联合检测对MIS-TLIF术后SSI具有较好的预测价值。 |
| 英文摘要: |
| Objective To explore the predictive value of neutrophil to lymphocyte ratio (NLR),derived neutrophil to lymphocyte ratio (dNLR) and systemic immune inflammation index (SII) for surgical site infection (SSI) after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Methods The clinical data of 198 patients with lumbar degenerative diseases undergoing MIS-TLIF in the hospital were collected between May 2019 and May 2022.The patients with postoperative SSI were included in SSI group,while those without infection were included in non-infection group.The general data,test results of blood routine and blood biochemistry in both groups were collected to calculate NLR,dNLR and SII.The predictive value of NLR,dNLR and SII for postoperative SSI was evaluated by ROC curves.Results There were significant differences in age,proportion of diabetes mellitus,operation time,intraoperative blood loss,Alb,WBC and hs-CRP levels between SSI group and non-infection group (P<0.05).The levels of dNLR,mLR and SII in SSI group were significantly higher than those in non-infection group (P<0.05).The multivariate Logistic regression analysis showed that advanced age,diabetes mellitus,long operation time and high levels of hs-CRP,NLR,dNLR and SII were independent risk factors of SSI (P<0.05).At 1d after surgery,AUC of dNLR combined with mLR and SII for predicting postoperative SSI was 0.903 (95%CI:0.819-0.956),greater than that of hs-CRP[0.836 (95%CI:0.740-0.907),P<0.05].Conclusions In patients with lumbar degenerative diseases undergoing MIS-TLIF,levels of NLR,dNLR and SII significantly increased in those with SSI at 1d after surgery.The combined detection of the three indexes has good predictive value for SSI after MIS-TLIF. |
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