中性粒细胞与淋巴细胞比值在老年人髋部骨折中的研究进展

Research Progress on Neutrophil-to-Lymphocyte Ratio in Hip Fracture in the Elderly

摘要: 老年人髋部骨折具有发病率高、并发症多及死亡率高等特点，围术期风险评估十分重要。中性粒细胞与淋巴细胞比值作为来源于血常规的炎症指标，因获取方便、成本低且可动态监测而受到关注。本综述总结了NLR在预测老年髋部骨折患者术后并发症和长期死亡率中的作用。NLR升高与深静脉血栓、术后谵妄、肺部感染以及1年死亡率密切相关。其预测价值可能与创伤后炎症增强和免疫功能受损有关。尽管检测时点及截断值存在差异，但NLR仍具有良好的风险分层价值。临床中应结合营养状态、凝血指标及评分系统综合评估。未来仍需多中心前瞻性研究进一步验证其应用价值。

Abstract: Hip fractures in the elderly are associated with high incidence, frequent complications, and increased mortality, making perioperative risk assessment essential. The neutrophil-to-lymphocyte ratio (NLR), an easily obtainable and low-cost inflammatory marker from routine blood tests, has gained attention for its clinical value. This review summarizes the role of NLR in predicting postoperative complications and long-term mortality in hip fracture in the elderly. Elevated NLR is closely related to deep vein thrombosis, postoperative delirium, pulmonary infection, and 1-year mortality. Its predictive value may be linked to enhanced inflammation and impaired immune function after trauma. Despite variations in timing and cutoff values, NLR remains a useful tool for risk stratification. In practice, it should be assessed in combination with nutritional status, coagulation markers, and clinical scores. Further multicenter prospective studies are needed to validate its clinical application.