血清炎性标志物对溃疡性结肠炎严重程度的预测价值

The predictive value of serum inflammatory markers in severity of ulcerative colitis

目的探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR)及全身免疫炎症指数(SII)对中重度溃疡性结肠炎(UC)严重程度的预测价值。方法回顾性分析2018年1月至2021年3月中国科学技术大学附属第一医院(安徽省立医院)收治的214名UC患者临床资料,根据改良Mayo评分将患者分为轻度组(90例)和中重度组(124例)。采用logistic回归分析确定中重度UC患者疾病严重程度相关危险因素。根据患者疾病状态绘制受试者工作特征(ROC)曲线,计算NLR、PLR、MLR及SII各指标对UC严重程度的预测价值。结果logistic回归分析结果显示,CRP、MLR和SII是中重度UC患者的危险因素。ROC曲线结果显示,NLR、MLR、PLR和SII预测UC严重程度的曲线下面积分别为0.744、0.762、0.706和0.764(P<0.001),最佳截断值分别为2.249、0.274、112.167和680.399;NLR预测UC严重程度的敏感度和特异度分别为75.81%和63.33%,MLR为79.03%和63.33%,PLR为87.10%和42.22%,SII为58.87%和82.22%。结论UC患者血清NLR、MLR、PLR和SII水平对UC疾病严重程度具有一定的预测价值,CRP、MLR和SII是中重度UC患者的危险因素。

Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),monocyte-lymphocyte ratio(MLR)and systemic immune-inflammation index(SII)in the severity of ulcerative colitis(UC).Methods The clinical records of 214 UC patients between January 2018 and March 2021 at the First Affiliated Hospital of the University of Science and Technology of China(USTC)were retrospectively analyzed.UC patients were divided into mild(90 cases)and moderate-to-severe(124 cases)groups according to the Modified Mayo score.Logistic regression models were used to determine disease severity-related risk factors.The predictive values of NLR,PLR,MLR and SII in moderate to severe ulcerative colitis were calculated using receiver operator characteristics(ROC)curves according to the disease status of patients.Results Logistic regression analysis indicated that CRP,high MLRand high SII were risk factors for the diagnosis of moderate-to-severe UC.ROC curves showed that the area under the curve for predicting UC severity was 0.744,0.762,0.706,0.764(P<0.001)for NLR,MLR,PLR and SII respectively,with the optimized cut-offs of NLR(2.249),MLR(0.274),PLR(112.167)and SII(680.399).The sensitivity and specificity was 75.81%and 63.33%for the NLR,79.03%and 63.33%for the MLR,87.10%and 42.22%for the PLR,58.87%and 82.22%for the SII.Conclusions CRP,high levels of MLR and SII are risk factors for the diagnosis of moderate-to-severe UC,which provide high clinical guiding significance.Serum NLR,MLR,PLR and SII levels in patients with ulcerative colitis have predictive values for the severity of UC.CRP,MLR and SII are risk factors for patients with moderate to severe UC.