复合炎症指标预测老年股骨粗隆间骨折术后小腿肌间静脉血栓形成的研究进展

Research Progress on the Predictive Value of Composite Inflammatory Indicators for Intermuscular Venous Thrombosis in the Calf Following Intertrochanteric Fracture Surgery in Elderly Patients

摘要: 老年股骨粗隆间骨折(IFF)患者术后易发生小腿肌间静脉血栓(MCVT)，目前早期预警仍缺乏简便、灵敏工具。近年研究提出，把常规血常规中的中性粒细胞、淋巴细胞、单核细胞和血小板进行组合，可得到全身炎症反应指数(SIRI)、全身免疫炎症指数(SII)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及单核细胞/淋巴细胞比(MLR)等复合指标。这些指标同时反映炎症与凝血激活状态，在骨折后的“免疫–血栓”过程中发挥关键预测作用。基于炎症标志物建立的复合炎症指标有望成为IFF术后MCVT风险评估的有效指标，对准确评估病情、识别血栓风险、改善预后具有现实意义。

Abstract: Postoperative patients with intertrochanteric fractures (IFF) in the elderly are prone to develop muscle interstitial venous thrombosis (MCVT) in the lower leg. Currently, there is still a lack of simple and sensitive early warning tools. Recent studies have proposed that by combining neutrophils, lymphocytes, monocytes and platelets in routine blood tests, composite indicators such as systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) can be obtained. These indicators simultaneously reflect the inflammatory and coagulation activation states and play a key predictive role in the “immune-thrombosis” process after fractures. Composite inflammatory indicators based on inflammatory markers are expected to become effective indicators for assessing the risk of MCVT after IFF surgery, which is of practical significance for accurately evaluating the condition, identifying thrombosis risks, and improving prognosis.