全身免疫炎症指数在儿童紫癜性肾炎中的预测价值  

Predictive value of systemic immune-inflammation index in children with Henoch-Schönlein purpura nephritis

作　　者：裘艺莎 吴锴 胡剑[1] 孙兴珍[1] QIU Yisha;WU Kai;HU Jian;SUN Xingzhen(Department of Pediatrics,The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院儿科,江苏淮安223300

出　　处：《安徽医药》2024年第12期2497-2501,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨全身免疫炎症指数(SII)对儿童紫癜性肾炎(HSPN)的预测价值。方法选取2019年6月至2022年12月于南京医科大学附属淮安第一医院住院治疗的161例过敏性紫癜病儿为研究对象,根据中华医学会儿科学分会肾脏病学组2016版HSPN诊治循证指南中HSPN的诊断标准分为非肾炎组95例和肾炎组66例,应用多因素logistic回归分析HSPN的独立危险因素;Spearman相关性分析检验SII与HSPN病理分级严重程度的相关性;利用受试者操作特征曲线(ROC曲线)评估SII对HSPN的预测价值。结果肾炎组SII水平显著高于非肾炎组[792.30(472.58,1428.01)×10^(9)/L比501.41(311.97,962.26)×10^(9)/L,Z=−3.07,P=0.002],不同病理级别肾炎组间SII水平差异有统计学意义(Z=−3.21,P=0.001);SII[OR=1.002,95%CI:(1.000,1.004),P=0.038]是HSPN的独立危险因素;SII水平与HSPN病理分级严重程度呈正相关(r=0.54,P<0.001);SII预测HSPN的曲线下面积为0.64[95%CI:(0.56,0.73),P=0.002],最佳截断值为390.03×10^(9)/L,灵敏度和特异度分别为83.31%和43.20%。结论SII对预测HSPN及评估病理严重程度有一定的临床应用价值。Objective To investigate the predictive value of systemic immune-inflammation index(SII)for Henoch-Schönlein purpura nephritis(HSPN)in children.Methods A total of 161 children with Henoch-Schönlein purpura who were hospitalized in The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from June 2019 to December 2022 were selected as the research objects.According to the diagnostic criteria of HSPN in the 2016 evidence-based Guidelines for the Diagnosis and Treatment of purpura nephritis,Nephrology Group,Branch of the Chinese Medical Pediatrics Society,the patients were divided into non-nephritis group(n=95)and nephritis group(n=66).Multivariate logistic regression analysis was used to analyze the independent risk factors of HSPN.Spearman correlation analysis was used to analyze the correlation between SII and the severity of pathological grading of HSPN.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of SII for HSPN.Results The level of SII in nephritis group was significantly higher than that in non-nephritis group[792.30(472.58,1428.01)×10^(9)/L vs.501.41(311.97,962.26)×10^(9)/L,Z=−3.07,P=0.002],and the level of SII has statistical difference between nephritis groups with different pathological grades(Z=−3.21,P=0.001);SII[OR=1.002,95%CI:(1.000,1.004),P=0.038]was an independent risk factor for HSPN;SII level was positively correlated with the severity of pathological grading of HSPN(r=0.54,P<0.001);The area under the curve of SII for predicting HSPN was 0.64[95%CI:(0.56,0.73),P=0.002],and the best cut-off value was 390.03×10^(9)/L,the corresponding sensitivity and specificity were 83.31%and 43.20%respectively.Conclusion SII has clinical value in predicting HSPN and evaluating the pathological severity.

关 键 词：过敏性紫癜性肾炎 全身免疫炎症指数 红细胞体积分布宽度 中性粒细胞计数/淋巴细胞计数比值 儿童 

分 类 号：R725.5[医药卫生—儿科]