全身免疫炎症指数对EB病毒致儿童传染性单核细胞增多症并肝损害的评估价值  

The Evaluation Value of SII in Pediatric Patients with Infectious Mononucleosis and Liver Damage Resulting from the Epstein-Barr Virus

作　　者：徐霞 赵陆华 XU Xia;ZHAO Luhua(Department of Rheumatolog,Linyi Central Hospital,Linyi,Shandong 276400,China;Department of Pediatric Medicine,Linyi Central Hospital,Linyi,Shandong 276400,China)

机构地区：[1]临沂市中心医院风湿免疫科,山东临沂276400 [2]临沂市中心医院儿内科,山东临沂276400

出　　处：《中国医药指南》2025年第10期29-32,共4页Guide of China Medicine

摘　　要：目的探讨全身免疫炎症指数(SII)对EB病毒致儿童传染性单核细胞增多症(IM)并肝损害的评估价值。方法选取临沂市中心医院2020年8月至2023年8月在收治的83例IM患儿作为研究对象。根据肝功能检查结果分为肝功正常组(31例)及肝损害组(52例)。选取同期急性化脓性扁桃体炎患儿30例为对照组。测定所有患儿治疗前血常规,根据结果分别计算SII、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR),并分析其在肝功正常组、肝损害组及对照组中的差异。比较各组患儿临床资料,采用受试者工作特征(ROC)曲线和二元Logistic回归分析确定IM患儿并肝损害的危险因素及SII对其的评估价值。结果IM组患儿中性粒细胞计数、SII、NLR、MLR、PLR较对照组患儿降低,淋巴细胞计数较对照组患儿升高(P<0.05)。肝损害组患儿血小板、中性粒细胞计数、单核细胞计数、SII、NLR、MLR、PLR较肝功正常组患儿降低(均P<0.05)。多因素二元Logistic回归分析结果显示SII、NLR是IM并肝损害的危险因素,治疗前IM并肝损害组患儿SII与NLR水平低于治疗后水平(P<0.05)。ROC曲线分析显示SII对IM并肝损害的最佳预测值为201.41,ROC曲线下面积(AUC)为0.849(95%CI 0.764~0.933,P<0.05),敏感性和特异性分别为80.80%、74.20%。NLR对IM并肝损害的最佳预测值为0.66,AUC为0.750(95%CI 0.640~0.860,P<0.05),敏感性和特异性分别为75.00%、67.70%;利用Logistic回归模型建立联合诊断,二者联合后AUC为0.866(95%CI 0.785~0.947,P<0.05),敏感性和特异性分别为88.50%、71.00%。结论IM患儿外周血SII水平降低可作为IM患儿并发肝损害的预测指标,特别是SII<201.41时高度提示肝损害的可能。Objective To investigate the diagnostic value of systemic immune inflammatory index(SII)in children with infectious mononucleosis(IM)and liver damage.Methods A total of 83 patients with IM children from Linyi Central Hospital from August 2020 to August 2023 were selected as the research objects.According to the results of liver function examination,they were divided into normal liver function group(31 cases)and liver damage group(52 cases).Thirty children with acute suppurative tonsillitis in the same period were selected as the control group.According to the results,SII,NLR,MLR,PLR were calculated,and the differences among the normal liver function group,liver damage group and control group were analyzed.The clinical data of children in each group were compared,and the risk factors of IM children with liver damage and the predictive value of SII were determined by receiver operating characteristic(ROC)curve and binary Logistic regression analysis.Results The neutrophil count,SII,NLR,MLR and PLR of children in IM group were lower than those in control group,and the lymphocyte count was higher than those in control group(P<0.05).The platelet count,neutrophil count,monocyte count,SII,NLR,MLR and PLR in the liver injury group were lower than those in the normal liver function group(all P<0.05).The results of multivariate binary Logistic regression analysis showed that SII and NLR were the risk factors of IM combined with liver damage,and the levels of SII and NLR in the children with IM combined with liver damage before treatment were lower than those after treatment(P<0.05).ROC curve analysis showed that the best predictive value of SII for IM and liver damage was 201.41,the area under ROC curve(AUC)was 0.849(95%CI 0.764-0.933,P<0.05),and the sensitivity and specificity were 80.8%and 74.2%,respectively.The best predictive value of NLR for IM and liver damage was 0.66,AUC was 0.750(95%CI 0.640-0.860,P<0.05),sensitivity and specificity were 75.0%and 67.7%,respectively.The combined diagnosis was established by Logis

关 键 词：传染性单核细胞增多症 全身免疫炎症指数 肝功能异常 EB病毒 

分 类 号：R725.1[医药卫生—儿科]