炎症相关指标对儿童炎症性肠病的诊断价值及列线图预测模型构建  

The Diagnostic Value of Inflammation Related Indicators for Inflammatory Bowel Disease in Children and the Construction of Nomogram Prediction Model

作　　者：黄昕昕 郝武娟 林琼[2] HUANG Xinxin;HAO Wujuan;LIN Qiong(Department of Pediatric Gastroenterology,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214000,China;Department of Gastroenterology,Wuxi Children’s Hospital,Wuxi 214000,China)

机构地区：[1]南京医科大学附属无锡人民医院儿童消化内科,江苏无锡214000 [2]无锡市儿童医院消化科,江苏无锡214000

出　　处：《标记免疫分析与临床》2024年第9期1653-1660,共8页Labeled Immunoassays and Clinical Medicine

基　　金：无锡市卫健委青年项目(编号:Q202332)。

摘　　要：目的分析炎症相关性指标对儿童炎症性肠病(inflammatory bowel disease,IBD)的诊断价值并构建IBD列线图预测模型。方法选择2020年1月至2023年8月无锡市儿童医院消化内科的炎症性肠病和非炎症性肠病的患儿。比较两组患儿的一般临床资料,采用相关性分析各指标与儿童发生炎症性肠病的关联性。受试者工作特征曲线(receiver operating characteristic curve,ROC)分析单个指标和联合指标的诊断价值。通过Lasso和逐步回归法筛选出最终变量,并构建列线图预测模型。结果本研究共纳入387例样本,其中炎症性肠病组163例,非炎症性肠病组224例。组间比较结果显示两组患者的家族史、肠道碱性磷酸酶(intestinal alkaline phosphatase,IAP)、中性粒细胞计数、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率、中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte count ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、血小板与白蛋白比值(platelet to albumin ratio,PAR)、系统性免疫炎症指数(systemic immune-inflammation index,SII)、淋巴细胞计数、血小板计数、白蛋白比较差异均有统计学意义(P<0.05)。相关性分析结果表明家族史(r=0.199,P<0.001)、中性粒细胞计数(r=0.915,P<0.001)、红细胞沉降率(r=0.608,P<0.001)、SII(r=0.464,P<0.001)、碱性磷酸酶(r=0.491,P<0.001)、C反应蛋白(r=0.423,P<0.001)、NLR(r=0.480,P<0.001)、PLR(r=0.353,P<0.001)、PAR(r=0.371,P<0.001)与炎症性肠病的发生呈正相关;淋巴细胞计数(r=-0.711,P<0.001)、血小板计数(r=-0.136,P=0.007)、白蛋白(r=-0.638,P<0.001)与炎症性肠病的发生呈负相关(P均<0.05)。进一步ROC分析结果显示,肠道碱性磷酸酶(AUC=0.741,95%CI 0.689~0.793),C反应蛋白(AUC=0.747,95%CI 0.690~0.804),NLR(AUC=0.781,95%CI 0.734~0.828),PLR(AUC=0.706,95%CI 0.653~0.759),PAR(AUC=0.717,95%CI 0.666~0.768),SII(AUC=0.756,95%CI 0.706~0.806)具有一定的诊断价值,各指标联合明显提高对�Objective To evaluate the diagnostic value of inflammation related indicators for inflammatory bowel disease(IBD)in children and to construct an IBD nomogram prediction model.Methods Children with inflammatory bowel disease and non-inflammatory bowel disease were selected from the Department of Gastroenterology at Wuxi Children’s Hospital from January,2020 to August,2023.We compared the general clinical information of these two groups of children and conducted correlation analysis to examine the potential correlation between various indicators and the occurrence of inflammatory bowel disease in children.Receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of individual and combined indicators.We then screened the final variables through Lasso and stepwise regression,and constructed a nomogram prediction model.Results This study included a total of 387 samples,including 163 cases in the inflammatory bowel disease group and 224 cases in the non-inflammatory bowel disease group.The intergroup comparison results showed statistically significant differences in family history,alkaline phosphatase,neutrophil count,C-reactive protein,erythrocyte sedimentation rate,neutrophil lymphocyte count ratio(NLR),platelet to lymphocyte ratio(PLR),platelet to albumin ratio(PAR),systemic immune inflammation index(SII),lymphocyte count,platelet count,and albumin comparison between the two groups of patients(P<0.05).The correlation analysis showed that family history(r=0.199,P<0.001),neutrophil count(r=0.915,P<0.001),erythrocyte sedimentation rate(r=0.608,P<0.001),SII(r=0.464,P<0.001),alkaline phosphatase(r=0.491,P<0.001),C-reactive protein(r=0.423,P<0.001),NLR(r=0.480,P<0.001),PLR(r=0.353,P<0.001),and PAR(r=0.371,P<0.001)were positively correlated with the occurrence of inflammatory bowel disease;Lymphocyte count(r=-0.711,P<0.001),platelet count(r=-0.136,P=0.007),and albumin(r=-0.638,P<0.001)were negatively correlated with the occurrence of inflammatory bowel disease(all P<0.05).ROC curves showed th

关 键 词：儿童炎症性肠病 炎症指标 肠道碱性磷酸酶 联合诊断 列线图 

分 类 号：R725.7[医药卫生—儿科]