Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, Japan,Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka-Cho, Obu, Aichi, Japan.
Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029061.
Legg-Calvé-Perthes disease (LCPD) presents with chronic nature of inflammation, characterized by prolonged synovitis. So far, no single blood marker has been identified to guide clinicians in estimating the severity and prognosis. Blood neutrophil to lymphocyte ratio (NLR) or systemic immune inflammation index (SII) is a simple indicator of subclinical inflammation. This study aims to examine the predictive ability of NLR, SII, and common laboratory parameters for estimating the severity of LCPD. The pre-operative laboratory findings at the time of osteotomy and implant removal in patients with unilateral LCPD who had been treated with the Salter innominate osteotomy and followed up until skeletal maturity as well as those of age-matched control patients with idiopathic noninflammatory conditions were analyzed. The datasets of 26 or 38 LCPD patients at the time of osteotomy or implant removal, respectively, and those of 20 control patients were available for analysis. At the time of osteotomy, compared to the control group, a significantly higher mean NLR or SII and a significantly lower mean alkaline phosphatase value were observed in the LCPD group. The alkaline phosphatase levels of patients with the modified lateral pillar (LP) group-A hips were significantly lower than those with the non-LP-A hips, whereas no significant differences were observed in any of the parameters between patients with favorable LP-A or -B hips and those with unfavorable LP-B|C border or -C hips. In agreement with the conventional opinion, it may be difficult to predict a meaningful prognosis of LCPD with the use of inflammatory markers or common laboratory parameters obtained in the initial stage of the disease.
Legg-Calvé-Perthes 病（LCPD）呈慢性炎症特征，表现为持续性滑膜炎。迄今为止，尚未发现单一的血液标志物可用于指导临床医生评估疾病的严重程度和预后。中性粒细胞与淋巴细胞比值（NLR）或全身免疫炎症指数（SII）是亚临床炎症的简单指标。本研究旨在探讨 NLR、SII 和常见实验室参数预测 LCPD 严重程度的能力。分析了接受 Salter 髂骨切开术治疗并随访至骨骼成熟的单侧 LCPD 患者在截骨和植入物取出时的术前实验室检查结果（共 26 例），以及年龄匹配的特发性非炎症性疾病对照组患者（共 20 例）的实验室检查结果。在截骨时，与对照组相比，LCPD 组的 NLR 或 SII 均值显著较高，碱性磷酸酶值显著较低。改良外侧柱（LP）组-A 髋关节患者的碱性磷酸酶水平明显低于非-LP-A 髋关节患者，而 LP-A 或 -B 髋关节患者与 LP-B|C 交界或 -C 髋关节患者之间的任何参数均无显著差异。与传统观点一致，使用疾病早期获得的炎症标志物或常规实验室参数可能难以预测 LCPD 的有意义预后。
