预后营养指数在客家人炎症性肠病严重程度及复发的应用研究

Application of prognostic nutritional index in the severity and recurrence of inflammatory bowel disease in Hakka

目的:评估预后营养指数(PNI)与客家人炎症性肠病(IBD)住院患者疾病严重程度及反复发作的关系,以早期判定疾病的程度、确定治疗方案及评估疾病的预后。方法:回顾性分析2019—2020年于梅州市人民医院住院的271例客家人IBD患者的一般情况、临床表现、肠镜检查结果、炎症严重程度、治疗药物、住院次数、血液学指标如PNI、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR),以克罗恩病活动指数、Mayo评分将患者分为轻度、中重度,根据住院次数将患者分为首次住院与反复发作住院,对以上数据进行统计分析。结果:271例患者中119例为克罗恩病(CD),152例为溃疡性结肠炎(UC),一般情况显示反复发作者病程较首次住院者的中位数病程更长,差异有统计学意义(P<0.05)。病变位于回肠及结肠的IBD更易反复发作,使用免疫抑制剂的频率较首次住院者更高。NLR、PLR、PNI能反映客家人IBD严重程度且特异度较高;PNI可预测IBD的反复发作,具有一定的灵敏度及特异度。结论:NLR、PLR、PNI预测客家人IBD严重程度、PNI预测IBD反复发作有临床参考价值。

Objective: In order to determine the severity of the disease early, determine the treatment plan for the disease, and evaluate the prognosis of the disease, we evaluate the relationship between the prognostic nutritional index(PNI) and the severity and recurrence of in Hakka patients with inflammatory bowel disease(IBD). Methods: Retrospective analysis of the general conditions, clinical manifestations, colonoscopy results, severity of inflammation, treatment drugs, number of hospitalizations, and hematological indicators of 271 Hakka patients with inflammatory bowel disease who were hospitalized in Meizhou People’s Hospital from 2019 to 2020.PNI, neutrophil to lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), Crohn’s disease activity index, Mayo score divides patients into mild and moderate to severe, and divides patients into first and relapsed according to the number of hospitalizations were statistically analyzed. Results: Among the 271 patients, 119 patients were diagnosed as Crohn’s disease(CD) and 152 were ulcerative colitis(UC). The general condition showed that the relapsed course was longer than the median course of first visits, and the difference was statistically significant. Inflammatory bowel disease with lesions located in the ileum and colon was more likely to relapse, and the frequency of using immunosuppressive agents is higher than that of first-time hospitalized patients. NLR, PLR, and PNI reflected the severity of inflammatory bowel disease in Hakka patients with a high specificity. PNI predicted the recurrence of inflammatory bowel disease with a certain sensitivity and specificity.Conclusion: NLR, PLR and PNI have clinical reference value in predicting the severity of inflammatory bowel disease in Hakka patients, and PNI in predicting the recurrence of inflammatory bowel disease.