全身免疫炎症指数对失代偿期肝硬化患者预后的评估价值  

Value of systemic immune inflammatory index on predicting the prognosis of patients with decompensated liver cirrhosis

作　　者：罗永祥[1] 周涛[1] Luo Yongxiang;Zhou Tao(Department of Digestive,the First People’s Hospital of Yibin,Yibin 64000,Sichuan Province,China)

机构地区：[1]宜宾市第一人民医院消化内科,四川宜宾644000

出　　处：《中国肝脏病杂志（电子版）》2021年第1期52-58,共7页Chinese Journal of Liver Diseases：Electronic Version

基　　金：宜宾市卫生健康委员会科研项目(2019352-36)。

摘　　要：目的探讨全身免疫炎症指数(systemic immune-inflammation index,SII)评估失代偿期肝硬化患者预后的价值。方法回顾性分析2016年2月至2019年9月宜宾市第一人民医院消化内科收治的196例失代偿期肝硬化患者的临床资料。收集患者性别、年龄、病史及病因等一般人口学资料和入院后首次实验室检查资料,包括总胆红素(total bilirubin,TBil)、γ-谷氨酰转移酶(γ-glutamyltransferase,GGT)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白蛋白(albumin,ALB)、血肌酐(serum creatinine,SCr)、尿素氮(blood urea nitrogen,BUN)、血清胱抑素(cystatin,Cys)、尿酸、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)、血清Na^(+)、国际标准化比值(international normalized ratio,INR)、白细胞计数(white blood count,WBC)、中性粒细胞计数、淋巴细胞计数、血小板(platelet,PLT)、血红蛋白(hemoglobin,Hb)、凝血酶原时间(prothrombin time,PT)等。计算SII、Child-Turcotte-Pugh(CTP)评分和终末期肝病模型(model for end-stage liver disease,MELD)评分。根据随访1年的疾病转归将患者分为存活组(136例)和病死组(60例),比较两组上述指标的差异。采用Cox比例风险回归模型分析失代偿期肝硬化患者预后的影响因素;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,评估SII、CTP评分和MELD评分对终末期肝硬化患者预后的预测价值;根据最佳截断值,将患者分为高SII组(96例)和低SII组(100例),采用Kaplan-Meier法分析两组生存率。结果病死组患者入院时并发上消化道出血(25例vs 22例)、WBC[(6.44±2.21)×10^(9)/L vs(4.39±1.51)×10^(9)/L]、中性粒细胞计数[(4.76±1.46)×10^(9)/L vs(2.76±1.00)×10^(9)/L]、淋巴细胞计数[(0.65±0.23)×10^(9)/L vs(0.94±0.37)×10^(9)/L]、PObjective To investigate the value of systemic immune inflammatory index(SII)on evaluating the prognosis of patients with decompensated liver cirrhosis.Methods The clinical data of 196 patients with decompensated liver cirrhosis admitted to the digestive department of the First People’s Hospital of Yibin from February 2016 to September 2019 were analyzed retrospectively.General demographic data such as gender,age,medical history and etiology,and the first laboratory examination data after admission including total bilirubin(TBil),gamma-glutamyltransferase(GGT),alanine aminotransferase(ALT),alkaline phosphatase(ALP),aspartate aminotransferase(AST),albumin(ALB),serum creatinine(SCr),blood urea nitrogen(BUN),serum cystatin(Cys),uric acid,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),serum Na,international normalized ratio(INR),white blood cell count(WBC),neutrophil count,lymphocyte count,platelet(PLT),hemoglobin(Hb)and prothrombin time(PT)were collected.The patients were divided into survival group(136 cases)and death group(60 cases)according to the outcome of one year follow-up.The clinical data of the two groups were compared.Cox proportional risk regression model was used to analyze the prognostic factors of patients with decompensated liver cirrhosis.The receiver operating characteristic(ROC)curve was drawn to evaluate the prediction effect of SII CTP score and MELD score on prognosis.According to the best cutoff value,the patients were divided into high SII group(96 cases)and low SII group(100 cases).The survival rates of the two groups were analyzed by Kaplan-Meier method.Results The upper gastrointestinal hemorrhage(25 cases vs 22 cases),WBC[(6.44±2.21)×10^(9)/L vs(4.39±1.51)×10^(9)/L],neutrophil count[(4.76±1.46)×10^(9)/L vs(2.76±1.00)×10^(9)/L],lymphocyte count[(0.65±0.23)×10^(9)/L vs(0.94±0.37)×10^(9)/L],PT[(19.22±3.10)s vs(17.27±3.16)s],INR(1.74±0.34 vs 1.41±0.33),TBil[(57.87±14.27)μmol/L vs(44.69±14.94)μmol/L],SII[(472.04±104.01)×10^(9)/L vs(28

关 键 词：肝硬化 失代偿期 全身免疫炎症指数 预后 

分 类 号：R575.2[医药卫生—消化系统]