The relationship between serum TLＲ-2，MCP-1，IL-6 levels and infection in patients with open fracture after opera-
tion Wang Xiaohu* ，Zhao Bo，Yu Shaomin，Liu Han，Mei Wei． * Department of Orthopedic，Hubei Hanchuan People＇s Hospi-
tal，Hubei Province，Xiaogan 431600，China
Corresponding author: Liu Han，E-mail: 532756981@ qq． com
Funding program: 2015-2016 Hubei Health Family Planning Youth Talent Project ( WJ2015Q008)
【Abstract】 Objective To analyze the relationship between the levels of serum Toll-like receptor 2 ( TLＲ-2) ，mono-
cyte chemoattractant protein-1 ( MCP-1) ，interleukin-6 ( IL-6) and infection in patients with open fracture after operation．
Methods Select 248 patients with open fractures who were diagnosed and treated in the Orthopedics Department of Hanchuan
People＇s Hospital of Hubei Province from October 2017 to July 2021 as the research object，and divide them into non-infection
group ( 170 cases) and infection group ( 78 cases) according to whether they have infection after operation． The levels of TLＲ-
2，MCP-1 and IL-6 in serum of the two groups at different time after operation were compared． Spearman correlation analysis
was used to analyze the correlation between the levels of TLＲ-2，MCP-1 and IL-6 in serum after operation and the degree of in-
fection． Multivariate logistic regression analysis was used to analyze the risk factors of postoperative infection in patients with
open fracture，and the subject work characteristic curve ( ＲOC) was drawn to predict the diagnostic value of various indicators
·503·疑难病杂志 2023 年 3 月第 22 卷第 3 期 Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

for postoperative infection in patients with open fracture． Ｒesults The proportion of operation time ≥ 3 hours，hospital stay
≥ 4 weeks，wound depth ≥ 2 cm，surgical site of lower limb，waist and hip，type II and type III surgical incision in the in-
fection group was higher than that in the non-infection group ( t / P = 5． 994 /0． 014，33． 188 / ＜ 0． 001，82． 687 / ＜ 0． 001，6．
491 /0． 011，15． 169 / ＜ 0． 001) ． The levels of TLＲ-2，MCP-1 and IL-6 in the infected group were higher than those in the
control group on the 3rd，5th and 7th day after operation ( P ＜ 0． 001) ，and the levels of TLＲ-2，MCP-1 and IL-6 in the in-
fected group increased gradually on the 3rd day after operation，reached the highest level on the 5th day after operation，and
then decreased; Spearman correlation analysis showed that the serum levels of TLＲ-2，MCP-1 and IL-6 were positively correla-
ted with the severity of the disease ( r / P = 0． 627 / ＜ 0． 001，0． 631 / ＜ 0． 001，0． 612 / ＜ 0． 001) ． Logistic regression analysis
showed that the operation time ≥ 3 hours，hospital stay ≥ 4 weeks，wound depth ≥ 2 cm，the operation site of lower limb，
waist and hip，surgical incision II and III，and the high serum TLＲ-2，MCP-1 and IL-6 on the fifth day after operation were
independent risk factors for postoperative infection in patients with open fracture ［OＲ ( 95% CI) = 19． 920 ( 8． 745 －
45． 374) ，17． 415 ( 7． 693 － 39． 441) ，37． 885 ( 15． 874 － 90． 415) ，27． 833 ( 12． 883 － 60． 132) 41． 390 ( 19． 374 － 88．
426) ，38． 755( 15． 273 － 98． 341) ，39． 103( 14． 941 － 102． 341) ，47． 743 ( 17． 826 － 127． 869) ］． The ＲOC curve showed
that the level of serum TLＲ-2，MCP-1，IL-6 and the area under the curve ( AUC) of the three combined to predict the diag-
nostic value of postoperative infection in patients with open fractures were 0． 839，0． 831，0． 828，and 0． 925，respectively．
The combined predictive efficiency of the three was higher than that of their individual prediction ( Z / P = 2． 493 /0． 017，2．
741 /0． 012，3． 000 /0． 007) ． Conclusion The serum levels of TLＲ-2，MCP-1 and IL-6 were significantly increased in pa-
tients with postoperative infection of open fractures． Clinical detection of their levels is helpful for early diagnosis and disease
judgment of postoperative infection．
【Key words】 Open fracture; Postoperative infection; Toll-like receptor 2; Monocyte chemoattractant protein-1; Inter-leukin-6