预后营养指数(PNI)和多发性肌炎/皮肌炎合并间质性肺疾病的相关性分析  

Correlation between Prognostic Nutritional Index (PNI) and Interstitial Lung Disease in Patients with Polymysitis/Dermatomyositis

作　　者：颜苏艳 李美琪 刘保成 杨清锐 麻贞贞 

机构地区：[1]山东第一医科大学附属省立医院风湿免疫科,山东 济南

出　　处：《临床医学进展》2023年第8期12421-12429,共9页Advances in Clinical Medicine

摘　　要：目的:探讨预后营养指数(PNI)在多发性肌炎/皮肌炎合并间质性肺疾病(PM/DM-ILD)的相关性以及PNI在PM/DM-ILD中的诊断价值。方法:回顾性分析270例PM/DM患者的临床资料,根据肺部影像结果分为多发性肌炎/皮肌炎合并间质性肺疾病组(PM/DM-ILD组,n = 147)及未合并间质性肺疾病组(对照组,n = 123),比较PM/DM-ILD组与对照组的PNI;采用Spearman秩相关分析及Pearson相关分析探讨PNI与其他实验室指标的相关性;采用二元logistics回归分析PM/DM合并ILD的危险因素;采用ROC曲线分析PNI对PM/DM合并ILD的诊断价值。结果:PM/DM-ILD组的PNI、白蛋白(ALB)、补体C3 (C3)、淋巴细胞计数(LY)、白细胞计数(WBC)、血小板计数(PLT)、单核细胞数(MO)及血红蛋白(Hb)水平均低于对照组(P 0.05)。相关分析结果显示,PM/DM-ILD患者PNI与LY、Hb、ALB、补体C3、PLT均呈正相关(rs = 0.638、0.338、0.926、0.369、0.348,P均<0.05),PNI与抗MDA5抗体呈负相关(rs = −0.460, P < 0.05)。二元logistics回归分析结果显示PNI水平的降低是PM/DM合并ILD的独立危险因素。PNI、ALB、LY诊断PM/DM合并ILD的ROC AUC值分别为0.838、0.824、0.718。结论:PM/DM-ILD患者PNI水平显著降低,PNI对于评估PM/DM合并ILD具有一定的临床诊断价值。Objective: To explore the relevance of prognostic nutritional index (PNI) in polymyositis/derma- tomyositis combined with interstitial lung disease (PM/DM-ILD) and the diagnostic value of PNI in PM/DM-ILD. Methods: Clinical data of 270 patients with PM/DM were collected. According to the presence or absence of imaging findings of ILD, they were divided into PM/DM-ILD group (n = 147) and control group (n = 123). PNI between the two groups was compared;Spearman rank correla-tion analysis and Pearson correlation analysis were used to study the correlation between PNI and other laboratory indicators;Binary logistic regression was used to analyze the risk factors of ILD in PM/DM;ROC curve was used to analyze the diagnostic value of PNI for ILD in PM/DM. Results: The levels of PNI, ALB, C3, LY, WBC, PLT, MO and Hb in PM/DM-ILD were lower than those in the control (P 0.05). The results of correlation analysis showed that PNI was positively correlated with LY, Hb, ALB and C3, PLT in patients with ILD (rs = 0.638, 0.338, 0.926, 0.369, 0.348, P < 0.05) and PNI was negatively correlated with anti-MDA5 (rs = −0.460, P < 0.05). Binary logistic regression analysis showed that the decrease of PNI level was an independent risk factor for ILD in PM/DM. The ROC AUC values of ILD in PM/DM diagnosed by PNI, ALB and LY were 0.838, 0.824 and 0.718 respectively. Conclusion: The level of PNI in PM/DM-ILD patients is significantly decreased. PNI has certain clinical diagnostic value in the evaluation of PM/DM with ILD.

关 键 词：皮肌炎 多发性肌炎 特发性炎症性肌病 间质性肺疾病 预后营养指数 

分 类 号：R73[医药卫生—肿瘤]