全身免疫炎症指数及常用血液指标对乳糜泻的诊断价值分析  

Analysis of diagnostic value of systemic immune inflammatory index and common blood indexes in celiac disease

作　　者：史甜 冯燕[1] 胡佳丽 王志远[1] 高峰[1] SHI Tian;FENG Yan;HU Jiali;WANG Zhiyuan;GAO Feng(Department of Gastroenterology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院消化科,新疆乌鲁木齐830001

出　　处：《国际消化病杂志》2022年第2期115-119,共5页International Journal of Digestive Diseases

摘　　要：目的探讨乳糜泻(CD)患者全身免疫炎症指数(SII)和常用血液指标水平的变化,以及其对CD的诊断价值。方法选择2016年1月至2021年1月新疆维吾尔自治区人民医院消化科收治的53例CD患者设为CD组,另选择同期收治的106例肠易激综合征(IBS)患者设为对照组。收集临床资料,比较两组的体质量指数(BMI)、SII及常用血液指标[血沉(ESR)、白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、白蛋白(ALB)]的差异,采用ROC曲线计算BMI、SII和上述血液指标的最佳截断值及ROC曲线下面积(AUC),并分析各项指标单项或两两联合检测的诊断效能。结果CD组的SII、WBC、PLT、ESR均明显高于对照组(P均<0.05),BMI、Hb和ALB水平均明显低于对照组(P均<0.05)。虽然这些指标诊断CD的AUC均较大、特异度均较高,但敏感度均较低。进一步对其中AUC较大的指标(Hb、ALB、PLT、SII、ESR、BMI及WBC)进行两两联合诊断CD的效能分析,结果显示ALB联合PLT诊断的AUC最大(0.875),敏感度为75.47%,特异度为93.40%;其次为SII联合ALB诊断的AUC(0.860),敏感度为73.58%,特异度为85.53%;Hb联合PLT诊断的AUC为0.838,敏感度为67.92%,特异度为90.57%;WBC联合ALB诊断的AUC为0.837,敏感度为79.25%,特异度为78.62%。上述各项指标两两联合诊断CD的效能均优于单项诊断。结论ALB与PLT、SII与ALB、Hb与PLT、WBC与ALB联合检测均具有较高的CD诊断价值。Objective This paper intends to explore the changes of systemic immune inflammatory index(SII)and common blood index levels in patients with celiac disease(CD),and their diagnostic value for CD.Methods 53 CD patients admitted to the Department of Gastroenterology,People's Hospital of Xinjiang Uygur Autonomous Region from January 2016 to January 2021 were selected and assigned to the CD group,and 106 patients with irritable bowel syndrome(IBS)admitted during the same period were selected and assigned to the control group,whose clinical data were collected.The differences in body mass index(BMI),SII and common blood indexes(erythrocyte sedimentation rate(ESR),white blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),and albumin(ALB))between the two groups were compared.The ROC curve was used to calculate the optimal cut-off value and area under the ROC curve(AUC)of BMI,SII and the above blood indicators,and the diagnostic performance of each indicator alone or in combination was analyzed.Results The SII,WBC,PLT,and ESR of the CD group are significantly higher,and the BMI,levels of Hb and ALB are significantly lower than those of the control group(P<0.05).Although the AUC of these indicators for the diagnosis of CD is larger and the specificity is higher,the sensitivity is lower.The efficacy of pairwise combined diagnosis of CD is further analyzed for the indicators with a larger AUC(Hb,ALB,PLT,SII,ESR,BMI,and WBC).The results show that the AUC in the diagnosis of ALB in combination with PLT is the largest(0.875),with a sensitivity of 75.47%and a specificity of 93.40%,followed by the AUC of SII in combination with ALB(0.860),with a sensitivity of 73.58%and a specificity of 85.53%.The AUC of Hb in combination with PLT is 0.838,the sensitivity is 67.92%,and the specificity is 90.57%.The AUC of WBC in combination with ALB is 0.837,the sensitivity is 79.25%,and the specificity is 78.62%.The efficacy of the combination of the above indicators in diagnosing CD is better than that of single diagnosis.Conclusion The co

关 键 词：乳糜泻 全身免疫炎症指数 血液指标 

分 类 号：R597.8[医药卫生—内科学] R446.6[医药卫生—临床医学]