摘要
目的探讨全身免疫炎症指数(systemic immune-inflammation index,SII)、预后营养指数(prognostic nutritional index,PNI)、白蛋白与球蛋白比值(albumin to globulin ratio,AGR)在溃疡性结肠炎(ulcerative colitis,UC)患者中的变化情况,评估其对中-重度UC的预测价值。方法选取2018年9月至2023年3月在徐州医科大学附属医院住院并确诊为UC的患者361例,根据改良Mayo评分分为缓解期组(n=36)、活动期组(n=325)(轻度组80例,中度组206例,重度组39例);根据Mayo内镜评分对肠黏膜病变程度进行评估;肠道病变范围采用蒙特利尔分型分为E1组90例,E2组129例,E3组117例。收集中性粒细胞、淋巴细胞、血小板、白蛋白、AGR、肠镜表现等,计算SII、PNI。分析各炎症-营养指标与UC不同严重程度、Mayo内镜评分及肠道病变范围的关系。结果中-重度组UC患者的SII水平显著高于非中-重度组患者,而PNI、AGR、Alb、BMI水平显著低于非中-重度组患者。随着UC疾病活动度的增加、肠道病变范围的扩大、肠道黏膜炎症的增加,SII显著升高,PNI、AGR显著降低(P<0.001)。Logistic回归分析显示SII、PNI、AGR、Alb是中-重度UC患者的独立影响因素;ROC曲线显示SII、PNI、AGR、Alb及联合指标均对UC严重程度有预测价值,其中联合指标SII+Alb+BMI对中-重度UC的预测价值最高,AUC为0.780(95%CI:0.734~0.822,P<0.001)。结论SII、PNI、AGR对UC严重程度有预测价值,可作为评估UC严重程度的潜在生物标志物。
Objective To investigate the changes of systemic immune-inflammation index(SII),prognostic nutritional index(PNI),albumin to globulin ratio(AGR)in ulcerative colitis(UC),and the predictive value for moderate to severe UC.Methods A total of 361 patients with UC admitted to the Affiliated Hospital of Xuzhou Medical University from Sep.2018 to Mar.2023 were selected.According to the modified Mayo score,the patients were divided into remission group(n=36)and active group(n=325),of which the active group was further divided into mild group(n=80),moderate group(n=206)and severe group(n=39).The degree of intestinal mucosal lesions was evaluated according to Mayo endoscopic score.The range of intestinal lesions was divided into E1 group(n=90),E2 group(n=129)and E3 group(n=117)by Montreal classification.Neutrophils,lymphocytes,platelets,albumin,AGR and colonoscopy findings were collected to calculate SII and PNI.The relationship between inflammatory nutritional biomarkers and the severity of UC,Mayo endoscopic score and the extent of intestinal lesions were analyzed.Results The SII level of UC patients in the moderate severe group was significantly higher than that in the non-moderate severe group,while the PNI,AGR,Alb and BMI levels were significantly lower than those in the non-moderate severe group.With the increase of UC disease activity,the expansion of the range of intestinal lesions,and the increase of intestinal mucositis,SII increased significantly,while PNI and AGR decreased significantly(P<0.001).Logistic regression analysis showed that SII,PNI,AGR and Alb were independent influencing factors of patients with moderate to severe UC;ROC curve showed that SII,PNI,AGR,Alb and combined indicators had predictive value,and the combined index SII+Alb+BMI had the highest predictive value for moderate to severe UC,with AUC of 0.780(95%CI:0.734-0.822,P<0.001).Conclusion SII,PNI and AGR have predictive value for the severity of UC,and can be used as potential biomarkers to evaluate the severity of UC.
作者
张萌
吴克俭
ZHANG Meng;WU Kejian(Clinical College of Xuzhou Medical University,Xuzhou 221000;Department of Gastroenterology,the Affiliated Hospital of Xuzhou Medical University,China)
出处
《胃肠病学和肝病学杂志》
CAS
2024年第9期1144-1148,共5页
Chinese Journal of Gastroenterology and Hepatology
