摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)及纤维蛋白原(FIB)水平对创伤性脊柱骨折合并脊髓损伤临床预后的预测价值。方法选取2016年1月至2019年6月该院脊柱外科收治的150例创伤性脊柱骨折合并脊髓损伤患者作为观察组,另选取同期该院100例体检健康志愿者作为对照组。检测并比较两组受试者的NLR、FIB水平。观察组患者伤后随访1年,根据其预后情况分为预后良好组(118例)和预后不良组(32例),收集观察组患者临床资料,包括年龄、性别、体质量指数、外伤类型、美国脊髓损伤协会(ASIA)脊髓损伤分级等。采用多因素Logistic回归分析影响创伤性脊柱骨折合并脊髓损伤患者临床预后的危险因素。采用受试者工作特征曲线(ROC曲线)分析NLR、FIB对患者预后不良的预测价值。结果与对照组比较,观察组外周血NLR、FIB水平均明显升高,差异均有统计学意义(P<0.05)。预后不良组患者外周血NLR和FIB水平与预后良好组比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,ASIA脊髓损伤分级为A+B级、NLR升高、FIB水平降低是创伤性脊柱骨折合并脊髓损伤预后不良的独立危险因素(P<0.05)。ROC曲线分析结果显示,联合检测NLR、FIB水平预测创伤性脊柱骨折合并脊髓损伤患者预后不良的曲线下面积为0.883,灵敏度和特异度分别为0.754、0.900。结论创伤性脊柱骨折合并脊髓损伤患者外周血NLR、FIB水平升高,其水平变化与其预后不良密切相关,可作为预测其临床预后的潜在指标。
Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)and fibrinogen(FIB)level in the clinical prognosis of traumatic spinal fracture combined with spinal cord injury.Methods A total of 150 patients with traumatic spinal fracture combined with spinal cord injury admitted to Department of Spinal Surgery in the hospital from January 2016 to June 2019 were selected as the observation group.In addition,100 healthy volunteers who underwent the physical examination in the hospital were selected as the control group.The NLR and FIB level of the two groups were detected and compared.The patients in the observation group were followed up for 1 year after injury,according to the prognosis of patients,they were divided into a good prognosis group(118 cases)and a poor prognosis group(32 cases).The clinical data of patients in the observation group were collected,including age,gender,body mass index,trauma type,American Spinal Injury Association(ASIA)spinal cord injury grade,etc.Multivariate Logistic regression analysis was used to analyze the risk factors affecting the clinical prognosis of patients with traumatic spinal fracture combined with spinal cord injury.Receiver Operating Characteristic curve(ROC curve)was used to analyze the predictive value of NLR and FIB for poor prognosis of patients.Results Compared with the control group,the peripheral blood NLR and FIB level in the observation group were significantly increased,and the differences were statistically significant(P<0.05).The differences on the peripheral blood NLR and FIB level between the poor prognosis group and the good prognosis group were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that ASIA spinal cord injury grade A+B,increase of NLR and decrease of FIB level were independent risk factors for poor prognosis in traumatic spinal fractures combined with spinal cord injury(P<0.05).ROC curve results showed that the area under the curve of combined detection of NLR and FIB for predicting the poor prognosis of patients was 0.883,and the sensitivity and the specificity were 0.754 and 0.900,respectively.Conclusion Peripheral blood NLR and FIB level elevate in patients with traumatic spinal fractures combined with spinal cord injury.Their level changes are closely related to the poor prognosis of patients,which could be used as potential indicators for predicting the clinical prognosis of patients.
作者
余东洋
何少波
唐忠秋
YU Dongyang;HE Shaobo;TANG Zhongqiu(Department of Spinal Surgery,Affiliated Hospital of Panzhihua University,Panzhihua,Sichuan 617000,China)
出处
《国际检验医学杂志》
CAS
2022年第20期2506-2509,2515,共5页
International Journal of Laboratory Medicine
基金
四川省医学科研课题计划(2015GK006)。
