炎症指数SII、NLR、PLR和GNRI对老年肌少症发生风险的评估价值  

Evaluation Value of Inflammatory Indices SII,NLR,PLR,and GNRI for the Risk of Sarcopenia in the Elderly

作　　者：刘晓铭[1] 邝盈妍 邓熙[2] 李忍 吕莹 谢苑芳 卞彩茹 邓斌[4] LIU Xiao-ming;KUANG Ying-yan;DENG Xi;LI Ren;LV Ying;XIE Yuan-fang;BIAN Cai-ru;DENG Bin(Department of Rehabilitation,Shenzhen Baoan District Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong,518101,China;Classical Chinese Medicine Ward,Shenzhen Baoan District Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong,518101,China;Department of Nutrition,Shenzhen Baoan District Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong,518101,China;Department of Cardiovascular Disease,Shenzhen Baoan District Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong,518101,China)

机构地区：[1]深圳市宝安区中医院康复科,广东深圳518101 [2]深圳市宝安区中医院中医经典病房,广东深圳518101 [3]深圳市宝安区中医院临床营养科,广东深圳518101 [4]深圳市宝安区中医院心血管病科,广东深圳518101

出　　处：《现代生物医学进展》2025年第7期1233-1239,共7页Progress in Modern Biomedicine

基　　金：深圳市宝安区2024年度区属公立医院高质量发展研究项目(BAGZL2024089,BAGZL2024090)。

摘　　要：目的:观察中性粒细胞/淋巴细胞比值(NLR)、全身免疫炎症指数(SII)、血小板/淋巴细胞比值(PLR)和老年营养风险指数(GNRI)对老年肌少症发生风险的评估价值。方法:纳入深圳市宝安区中医院2023年7月至2024年7月期间收治的老年患者146例。依据是否发生肌少症分为肌少症组和非肌少症组。对比肌少症组和非肌少症组的临床资料,采用多因素Logistic回归分析老年肌少症发生的影响因素。采用Pearson法分析SII、NLR、PLR与GNRI的相关性。采用受试者工作特征(ROC)曲线分析炎症指数SII、NLR、PLR和GNRI对老年肌少症发生的预测效能。结果:肌少症组和非肌少症组的年龄、握力、步速、GNRI、SII、NLR、PLR、血红蛋白(Hb)组间对比有差异(P<0.05)。多因素Logistic回归分析显示,年龄偏大、GNRI偏低、SII偏高、NLR偏高、PLR偏高是老年患者发生肌少症的危险因素(P<0.05)。Pearson法分析结果显示:GNRI与炎症指数SII、NLR、PLR呈正相关(P<0.05)。ROC曲线分析显示,炎症指数SII、NLR、PLR和GNRI对老年肌少症发生风险的灵敏度、特异度、曲线下面积(AUC)为84.13%、90.36%、0.941,均高于各指标单一检测。结论:年龄偏大、GNRI偏低、SII偏高、NLR偏高、PLR偏高是老年患者发生肌少症的危险因素,联合检测预测价值较高。Objective:To observe the evaluation value of inflammatory indices neutrophil/lymphocyte ratio( NLR),systemic immune inflammation index( SII),platelet/lymphocyte ratio( PLR),and geriatric nutritional risk index( GNRI) for the risk of sarcopenia in the elderly.Methods:146 elderly patients who were admitted to Shenzhen Baoan District Hospital of Traditional Chinese Medicine from July 2023 to July 2024 were included.The patients were divided into muscle atrophy group and non muscle atrophy group according to whether muscle atrophy occurs.The clinical data between sarcopenia group and non sarcopenia group were compared,the influencing factors of sarcopenia in the elderly were analyzed by multiple logistic regression analysis.The correlation between SII,NLR,PLR and GNRI was analyzed by pearson method.The predictive efficacy of inflammatory indices SII,NLR,PLR and GNRI for the occurrence of sarcopenia in the elderly was analyzed by receiver operating characteristic( ROC) curve.Results:There were differences in age,grip strength,step speed,GNRI,SII,NLR,PLR,hemoglobin( Hb) between sarcopenia group and non sarcopenia group( P<0.05).Multivariate logistic regression analysis showed that,older age,lower GNRI,higher SII,higher NLR and higher PLR were risk factors for sarcopenia in elderly patients( P<0.05).Pearson analysis results showed that,GNRI was positively correlated with inflammatory indices SII,NLR and PLR( P<0.05).ROC curve analysis showed that,the sensitivity,specificity and area under the curve( AUC) of inflammatory indices SII,NLR,PLR and GNRI for the risk of sarcopenia in the elderly were 84.13 %,90.36 % and 0.941 respectively,which were higher than those detected by single indicators.Conclusion:Older age,lower GNRI,higher SII,higher NLR,and higher PLR are risk factors for sarcopenia in elderly patients,and combined detection has high predictive value.

关 键 词：全身免疫炎症指数 老年营养风险指数 血小板淋/巴细胞比值 中性粒细胞/淋巴细胞比值 老年 肌少症 

分 类 号：R3[医药卫生—基础医学] R685