【摘要】 目的 探讨C反应蛋白（CRP）/白蛋白（ALB）比值（CAR）与开放性手外伤术后感染的相关性分析。方法 回顾性选取2022年1月至2024年12月于新乡医学院第一附属医院手外科手术治疗的36例术后30天内发生感染的开放性手外伤患者作为感染组，选取同期于本院手外科手术治疗的术后30天内未发生感染的114例开放性手外伤患者作为非感染组。收集两组的基线资料及术前CRP和ALB数值，计算CAR。采用Spearman相关分析检验CAR与感染的相关性，采用受试者工作特征曲线评估CAR等指标对感染的预测效能，采用多因素Logistic逐步回归分析确定术后感染的独立危险因素。结果 感染组患者的血清CRP、CAR高于非感染组，ALB低于非感染组，差异有统计学意义（P<0.05）。血清CRP、CAR与开放性手外伤术后感染呈正相关（r=0.412、0.609,P<0.05），血清ALB与开放性手外伤术后感染呈负相关（r=-0.387,P<0.05）。血清CRP、ALB及CAR预测开放性手外伤术后感染的AUC(95%CI)分别为0.817(0.772～0.867)、0.784(0.734～0.829)、0.902(0.857～0.947)。感染组年龄≥60岁、ASA评分≥Ⅲ级、受伤至手术时间≥6h以及合并糖尿病的人数占比高于非感染组，差异有统计学意义（P<0.05）。多因素分析显示：年龄（OR=1.910,95%CI:1.065～3.425）、受伤至手术时间（OR=2.038,95%CI:1.196～3.473）、合并糖尿病（OR=2.593,95%CI:1.309～5.140）、CAR(OR=3.121,95%CI:1.875～5.194)是开放性手外伤术后感染的独立影响因素（P<0.05）。结论 CAR为术前易获得的炎症复合指标，与开放性手外伤术后感染风险密切相关，对完善围术期风险评估体系具有潜在意义。更多还原

【Abstract】 Objective To explore the correlation between the C-reactive protein(CRP)/albumin(ALB) ratio(CAR) and postoperative infection in open hand injuries. Methods A retrospective study was conducted on 36 patients with open hand injuries who developed infections within 30 days after surgery in the hand surgery department at The First Affiliated Hospital of Xinxiang Medical University from January 2022 to December 2024, categorized as the infection group. Additionally, 114 patients with open hand injuries who did not develop infections within 30 days after surgery during the same period were included in the non-infection group. Baseline data, preoperative CRP, and ALB values of the two groups were collected, and the CAR was calculated. The correlation between CAR and infection was evaluated through Spearman correlation analysis, and the predictive efficacy of CAR and other indicators for infection was investigated using the ROC curve. Independent risk factors for postoperative infection were determined through multivariate logistic stepwise regression analysis. Results The serum levels of CRP and CAR in patients from the infected group were higher compared to those from the non-infected group, while ALB levels were lower in the infection group, with statistically significant differences(P<0.05). Serum CRP and CAR were positively correlated with postoperative infection in open hand injuries(r=0.412, 0.609, P<0.05), while serum ALB showed a negative correlation(r=-0.387, P<0.05). The AUC(95%CI) of serum CRP, ALB, and CAR for predicting postoperative infection in open hand injuries were 0.817(0.772～0.867), 0.784(0.734～0.829), and 0.902(0.857～0.947), respectively. The number of patients aged 60 years or older, with an ASA score ≥ GradeⅢ, a time from injury to operation ≥6 h, and diabetes in the infected group was higher than in the non-infected group(P<0.05). Multivariate analysis revealed that age(OR=1.910, 95%CI: 1.065～3.425), time from injury to surgery(OR=2.038, 95%CI: 1.196～3.473), diabetes(OR=2.593, 95%CI: 1.309～5.140), and CAR(OR=3.121, 95%CI: 1.875～5.194) were independent risk factors for postoperative infection in open hand injuries(P<0.05). Conclusion CAR is an easily obtainable inflammatory marker that can be measured before surgery. It is closely related to the risk of postoperative infection in cases of open hand trauma and has the potential to improve the perioperative risk assessment system.更多还原