【摘要】 目的 探讨血小板/淋巴细胞比值（PLR）对老年断指再植患者术后血管危象（VC）发生的预测效能。方法 选取2021年2月至2024年8月新乡医学院第一附属医院收治的158例老年断指再植患者作为本次研究对象，根据术后是否发生VC分为VC组（n=37）和非VC组（n=121）。采用全自动血液细胞分析仪检测血小板计数（PLT）、淋巴细胞计数（LYM），并计算二者比值（PLR=PLT/LYM）；采用受试者工作特性（ROC）曲线评估PLT、LYM、PLR对老年断指再植患者术后VC的预测价值；采用多因素Logistic逐步回归分析老年断指再植患者术后VC的影响因素。结果 VC组PLT、PLR高于非VC组，LYM低于非VC组，差异有统计学意义（P<0.05）。PLT、LYM、PLR预测老年断指再植患者术后VC的曲线下面积（AUC）(95%CI)分别为0.861(0.808～0.914)、0.756(0.698～0.804)、0.903(0.853～0.959)，截断值分别为215.69×10~9、1.39×10~9、161.40，特异度分别为0.681、0.572、0.862，灵敏度分别为0.903、0.903、0.844。VC组年龄高于非VC组，糖尿病史、离断程度（完全）、受伤至入院时间≥6 h、离断平面（末节）、静脉修复（未吻合）、动脉修复（1根）所占比例均大于非VC组，差异有统计学意义（P<0.05）。多因素分析显示，受伤至入院时间≥6 h、离断平面（末节）、PLR≥161.40是老年断指再植患者术后VC的危险因素（OR>1,P<0.05）。结论 PLR升高与老年断指再植患者术后VC有关，PLR对患者术后VC具有较高的预测效能。更多还原

【Abstract】 Objective To explore the predictive efficacy of platelet-to-lymphocyte ratio(PLR) for postoperative vascular crisis(VC) in elderly cases undergoing replantation of severed fingers. Methods A total of 158 elderly cases who underwent replantation of severed fingers in our hospital from February 2021 to August 2024 were selected as the research subjects. They were divided into VC group(n=37) and non-VC group(n=121) based on whether VC occurred after surgery. Platelet count(PLT) and lymphocyte count(LYM) were detected by an automatic blood cell analyzer, and the ratio of the two(PLR=PLT/LYM) was calculated. The predictive value of PLT, LYM, and PLR for postoperative VC in elderly cases undergoing replantation of severed fingers was evaluated by the ROC curve. The influencing factors of postoperative VC in elderly cases undergoing replantation of severed fingers were explored by multivariate Logistic stepwise regression. Results The PLT and PLR of the VC group were higher than those of the non VC group, and the LYM was lower than that of the non VC group, with statistically significant differences(P<0.05). The area under the curve(AUC)(95% CI) of PLT, LYM, and PLR for predicting postoperative VC in elderly cases undergoing replantation of severed fingers were 0.861(0.808～0.914), 0.756(0.698～0.804), and 0.903(0.853～0.959), respectively. The age of VC group was higher than that of non VC group, the history of diabetes, the degree of disconnection(complete), the time from injury to hospital admission ≥6 h, the proportion of disconnection plane(distal segment), venous repair(not anastomosed), and arterial repair(1 root) in VC group were higher than that in non VC group, and the difference was statistically significant(P<0.05). Multivariate analysis showed that the time from injury to admission ≥6 h, the level of amputation(distal segment), and PLR≥161.40 were the risk factors for postoperative VC in elderly patients with severed finger replantation(OR>1)(P<0.05). Conclusion The increase of PLR is related to postoperative VC in elderly patients with replantation of severed fingers. PLR has a high predictive efficiency for postoperative VC.更多还原