Wang Zhongzheng, Tian Siyu, Zhao Kuo, Zhang Ruipeng, Yin Yingchao, Zhu Yanbin, Hou Zhiyong, Zhang Yingze
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, China.
Int Orthop. 2020 Dec;44(12):2769-2777. doi: 10.1007/s00264-020-04793-6. Epub 2020 Sep 8.
The neutrophil-to-lymphocyte ratio (NLR) has recently been found to be closely associated with the severity of trauma. This study aimed to analyze the correlation between the imaging severity of isolated tibial plateau fractures (TPFs) and the NLR in the blood.
A total of 223 patients with isolated TPFs were enrolled in this retrospective study over five years. The data at hospital admission were extracted from an electronic database. Schatzker classification was performed according to the imaging data by two experienced orthopaedic surgeons. All patients were divided into two groups: group 1 included patients with mild-to-moderate fractures (Schatzker types I-IV), and group 2 included patients with severe fractures (Schatzker types V-VI). The NLR levels at hospital admission were statistically compared between the two groups.
The blood NLR, hemoglobin level, red blood cell count, neutrophil count, platelet count, time from injury to admission, total protein, and Na levels were significantly different among the two groups. According to the receiver operating characteristic (ROC) curve, the cutoff for the NLR was 5.8. ROC curve analysis showed that the sensitivity of an NLR ≥ 5.8 to predict severe TPFs was 53.4%, and the specificity was 70.7%. In the multivariate analysis, NLR ≥ 5.8 and haemoglobin < lower limit appeared to be independent predictors of severe TPFs.
Our study is the first to demonstrate that the NLR level appears to be a useful biomarker for predicting the severity of isolated TPFs in young and middle-aged adults.
最近发现中性粒细胞与淋巴细胞比值（NLR）与创伤严重程度密切相关。本研究旨在分析单纯胫骨平台骨折（TPF）的影像学严重程度与血液中NLR之间的相关性。
本回顾性研究共纳入223例单纯TPF患者，研究时间跨度为五年。入院时的数据从电子数据库中提取。由两名经验丰富的骨科医生根据影像学数据进行Schatzker分类。所有患者分为两组：第1组包括轻度至中度骨折患者（Schatzker I-IV型），第2组包括重度骨折患者（Schatzker V-VI型）。对两组患者入院时的NLR水平进行统计学比较。
两组患者的血液NLR、血红蛋白水平、红细胞计数、中性粒细胞计数、血小板计数、受伤至入院时间、总蛋白和钠水平存在显著差异。根据受试者工作特征（ROC）曲线，NLR的临界值为5.8。ROC曲线分析显示，NLR≥5.8预测重度TPF的敏感性为53.4%，特异性为70.7%。在多变量分析中，NLR≥5.8和血红蛋白<下限似乎是重度TPF的独立预测因素。
我们的研究首次表明，NLR水平似乎是预测中青年单纯TPF严重程度的有用生物标志物。
