自身炎症性疾病患者合并COVID-19严重程度的早期预测指标探讨  

Early predictors of the severity of COVID-19 in patients with autoinflammatory diseases

作　　者：吕梦娜 李建斌 吴锐[2] LYU Mengna;LI Jianbin;WU Rui(The First Clinical Medical College of Nanchang University,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Rheumatology and Immunology,the First Affiliated Hospital of Nanchang University)

机构地区：[1]南昌大学第一临床医学院,330006 [2]南昌大学第一附属医院风湿免疫科

出　　处：《天津医药》2024年第5期528-532,共5页Tianjin Medical Journal

摘　　要：目的探讨血细胞比值及炎症指标对自身炎症性疾病(AIDs)合并新型冠状病毒肺炎(COVID-19)严重程度的预测价值。方法148例AIDs合并COVID-19患者根据COVID-19严重程度分为轻症组100例和重症组48例。比较2组患者感染后24~72 h内的红细胞沉降率(ESR)、C反应蛋白(CRP)、系统免疫炎症指数(SII)和白细胞-C反应蛋白比值(LeCR)等指标差异;采用Logistic回归分析AIDs合并COVID-19严重程度的危险因素;受试者工作特征(ROC)曲线评估各指标对AIDs合并COVID-19严重程度的预测价值。结果重症组ESR、CRP、血小板计数(PLT)、中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、C反应蛋白-淋巴细胞比值(CLR)、C反应蛋白-白蛋白比值(CAR)、SII和血小板-白蛋白比值(PAR)高于轻症组,平均血小板体积(MPV)、淋巴细胞计数(LYM)、白蛋白(Alb)和LeCR低于轻症组(P<0.05)。Logistic回归分析显示,ESR升高是AIDs合并COVID-19严重程度的独立危险因素,LeCR和SII升高是保护因素。ROC曲线分析显示,LeCR对AIDs合并重症COVID-19的预测效能优于ESR和SII。结论ESR、SII和LeCR是预测AIDs并发COVID-19疾病严重程度的有效指标。Objective To investigate the value of blood cell ratio and inflammation index in predicting the severity of autoinflammatory disease(AIDs)complicated by corona virus disease 2019(COVID-19).Methods Based on the severity of COVID-19,148 patients with AIDs combined with COVID-19 were categorized into two groups:the mild case group(n=100)and the severe case group(n=48).Laboratory indicators,including erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),systemic immune-inflammation index(SII)and white blood cell to C-reactive protein ratio(LeCR),were compared between the two groups within 24 to 72 h after infection.Logistic regression was used to analyze risk factors for the severity of AIDs patients with COVID-19.Receiver operating characteristic(ROC)curves were used to assess the predictive value of indicators for the severity of AIDs and COVID-19.Results ESR,CRP,platelet count(PLT),neutrophil-tolymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),C-reactive protein-to-lymphocyte ratio(CLR),C-reactive protein-to-albumin ratio(CAR),SII and platelet-to-albumin ratio(PAR)were higher in the severe case group than those in the mild case group.The mean platelet volume(MPV),lymphocyte count(LYM),albumin count(Alb)and LeCR levels were lower in the severe case group than those in the severe case group(P<0.05).Logistic regression analysis indicated that elevated levels of ESR was an independent risk factor for the severity of COVID-19 in patients with AIDs,while increased levels of LeCR and SII acted as protective factors.ROC curve analysis demonstrated that LeCR was better than ESR and SII in predicting the severe of COVID-19 in AIDs patients.Conclusion ESR,SII and LeCR are effective indicators for predicting the severity of disease associated with AIDs and COVID-19.

关 键 词：自身炎症性疾病 新型冠状病毒肺炎 预后 白细胞-C反应蛋白比值 

分 类 号：R593.2[医药卫生—内科学]