[1]李承思 邢欣 王忠正 王宇钏 程晓东 李栋正 陈伟 张英泽 张奇.术前高敏C反应蛋白与淋巴细胞比值预测退变性腰椎手术后手术部位感染的价值[J].中华老年骨科与康复电子杂志,2026,(01):3-14.[doi:10.3877/cma.j.issn.2096-0263.2026.01.002]
　Li Chengsi,,et al.The value of preoperative high-sensitivity c-reactive protein to lymphocyte ratio in predicting surgical site infection following degenerative lumbar spine surgery[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2026,(01):3-14.[doi:10.3877/cma.j.issn.2096-0263.2026.01.002]
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术前高敏C反应蛋白与淋巴细胞比值预测退变性腰椎手术后手术部位感染的价值()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2026年01期
页码:
3-14
栏目:
术后感染
出版日期:
2026-02-05

文章信息/Info

Title:
The value of preoperative high-sensitivity c-reactive protein to lymphocyte ratio in predicting surgical site infection following degenerative lumbar spine surgery
作者:
李承思1; 2; 3 邢欣1; 2; 3 王忠正1; 2; 3 王宇钏1; 2; 3 程晓东1; 2; 3 李栋正1; 2; 3 陈伟1; 2; 3 张英泽1; 2; 3 张奇1; 2; 3
050051 石家庄，河北省骨科研究所1，河北省骨科生物力学重点实验室2，河北医科大学第三医院创伤急救中心3
Author(s):
Li Chengsi1;  2;  3;  Xing Xin1;  2;  3;  Wang Zhongzheng1;  2;  3;  Wang Yuchuan1;  2;  3;  Cheng Xiaodong1;  2;  3;  Li Dongzheng1;  2;  3;  Chen Wei1;  2;  3;  Zhang Yingze1;  2;  3;  Zhang Qi1;  2;  3.
1Orthopedic Research Institution of Hebei Province; 2Key Laboratory of Biomechanics of Hebei Province; 3Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
关键词:
腰椎手术;  手术部位感染;  高敏C反应蛋白与淋巴细胞比值;  系统性炎症;  预测因素
Keywords:
Lumbar surgery;  Surgical site infection;  High-sensitivity C-reactive protein to lymphocyte ratio;  Systemic inflammation;  Predictive factors
DOI:
10.3877/cma.j.issn.2096-0263.2026.01.002
文献标志码:
A
摘要:
目的 探究术前高敏C反应蛋白与淋巴细胞比值（hs-CLR）与退变性腰椎手术后手术部位感染（SSI）的关系，并评估其作为系统性炎症标志物的实际预测能力。方法 回顾收集2020至2024年在本院进行择期腰椎手术的1 338例退行性腰椎管狭窄或腰椎滑脱病患资料，包括基线信息、合并症、检验学结果及围术期变量。依据美国疾控中心标准诊断SSI，并随访至少12个月。以术前hs-CLR为连续自变量，在多因素Logistic回归模型的框架下构建限制性立方样条模型，评估hs-CLR与SSI的剂量-效应关系，并确定转折点。根据界值，将患者分成低hs-CLR组（＜2.40）和高hs-CLR组（≥2.40）；采用1:1倾向评分匹配调整术前基线差异，在未匹配队列和匹配队列中分别构建多因素条件Logistic回归模型，评估高hs-CLR与SSI的独立关系。结果 队列SSI发生率为3.6%（48/1 338）。与未发生SSI的患者相比，SSI组患者体重指数、红细胞沉降率、hs-CRP、空腹血糖和hs-CLR均明显更高（P＜0.05）。限制性立方样条分析显示，术前hs-CLR同SSI风险直接有显著整体关联，且呈近似线性上升趋势。以2.40为分界，匹配前队列高hs-CLR组发生SSI风险较高，多变量调整比值比（aOR）为1.96（95% CI：1.07，3.61）。匹配后获得386对患者，高hs-CLR组风险进一步提升，aOR为3.53（95% CI：1.37，9.08）。ROC显示hs-CLR的曲线下面积达0.722。结论 术前hs-CLR增高与退变性腰椎手术后SSI风险密切相关，在调整传统因素和手术变量后，仍是独立预测因素。hs-CLR基于常规术前检查计算，便捷实用，有望用于腰椎手术患者行风险评估和个性化管理。
Abstract:
Objective To explore the link between preoperative high-sensitivity C-reactive protein to lymphocyte ratio (hs-CLR) and surgical site infection (SSI) following surgery for degenerative lumbar conditions, and to assess hs-CLR’s potential as an inflammatory indicator for prediction. Methods We retrospectively gathered data from 1, 338 patients who had elective lumbar surgery for degenerative lumbar spinal stenosis or spondylolisthesis from 2020 to 2024 at our facility. This included demographics, comorbidities, preoperative lab tests (such as high-sensitivity C-reactive protein [hs-CRP] and lymphocyte count), and perioperative details. SSI was identified using Centers for Disease Control and Prevention (CDC) guidelines, with follow-up lasting at least 12 months. Treating hs-CLR as a continuous factor, we built a restricted cubic spline model in multivariable logistic regression to map the dose-response between hs-CLR and SSI, identifying the turning point. Patients were grouped into low-hs-CLR (<2.40) and high-hs-CLR (≥2.40). We used 1:1 propensity score matching (PSM) to even out preoperative baselines. Multivariable logistic models were set up for the unmatched group, and conditional ones for the matched, to check the standalone connection between high hs-CLR and SSI. Results SSI rate in the group was 3.6% (48/1, 338). Compared to those without SSI, SSI cases showed notably higher BMI, ESR, hs-CRP, FBG, and hs-CLR (all P<0.05). Spline analysis revealed a clear overall tie between preoperative hs-CLR and SSI risk, with a nearly straight upward trend. Using 2.40 as cutoff, unmatched high-hs-CLR had higher SSI odds, with adjusted odds ratio (aOR) of 1.96 (95% CI: 1.07, 3.61). After PSM yielding 386 pairs, high-hs-CLR risk rose further, aOR 3.53 (95% CI: 1.37, 9.08). ROC showed hs-CLR AUC at 0.722, better than CALLY (0.689), CAR (0.678), and NLR (0.547). Conclusions Elevated preoperative hs-CLR links strongly to SSI risk post-degenerative lumbar surgery and stands as an independent predictor even after adjusting for standard risks and surgical elements. Calculated from routine preoperative labs, hs-CLR offers a simple tool for risk layering and tailored care in lumbar surgery patients.

备注/Memo

备注/Memo:
基金项目：河北省重点研发计划项（21377731D）
更新日期/Last Update: 2026-05-18