系统性免疫-炎症指数和全身炎症评分联合检测在强直性脊柱炎中的诊断价值研究

Predictive Value of Combined Detection of Systemic Immune-inflammatory Index and Systemic Inflammation Score in Ankylosing Spondylitis

目的探讨系统性免疫-炎症指数(systemic immune-inflammation index,SII)、全身炎症评分(systemic inflammation score,SIS)在强直性脊柱炎(ankylosing spondylitis,AS)中的诊断价值。方法回顾性收集在徐州医科大学附属医院风湿免疫科住院的符合纳入标准的AS患者128例作为AS组,并随机选取笔者医院健康体检者110例作为对照组。收集两组患者的临床资料及血生化指标,计算SII、SIS并进行统计学分析。结果AS组患者的中性粒细胞计数、红细胞分布宽度、血小板计数、单核细胞计数、血小板/淋巴细胞比值(platelet/lymphocyte ratio,PLR)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)、SIS、SII均高于对照组,而淋巴细胞计数、白蛋白(albumin,ALB)、淋巴细胞/单核细胞比值(lymphocyte/monocyte ratio,LMR)水平较低(P<0.05),Spearman相关分析显示SII、SIS与RDW呈正相关(rs>0,P<0.05),与MPV呈负相关(rs<0,P<0.05),且SII与白蛋白呈负相关(rs<0,P<0.001)。多因素Logistic回归分析显示RDW、SII、SIS均是AS的独立危险因素(P<0.05),SII、SIS诊断AS的曲线下面积(area under curve,AUC)分别是0.712、0.681。二者联合检测AUC为0.734,特异性(87.3%)显著高于单一指标检测(82.7%、80.9%)。结论SII、SIS是强直性脊柱炎的独立危险因素,可作为临床辅助诊断指标,二者联合检测能够提高AS的早期诊断率。

Objective To investigate the diagnostic value of systemic immune-inflammatory index(SII)and systemic inflammation score(SIS)in ankylosing spondylitis(AS).Methods A total of 128 AS patients who met the inclusion criteria in the Department of Rheumatology and Immunology,Affiliated Hospital of Xuzhou Medical University were retrospectively collected as the AS group,and 110healthy subjects in our hospital were randomly selected as the control group.The clinical data and blood biochemical indexes of the two groups of patients were collected,and the SII and SIS were calculated and analyzed.Results The levels of neutrophils,red blood cell distribution width,platelets,monocytes,platelet/lymphocyte ratio(PLR),neutrophil/lymphocyte ratio(NLR),SIS,and SII in the AS group were higher than those in the control group,while the levels of lymphocytes,albumin,and lymphocyte/monocyte ratio(LMR)were lower(P<0.05).Spearman correlation analysis showed that SII,SIS were positively correlated with red blood cell distribution width(RDW)(rs>0,P<0.05),negatively correlated with MPV(rs<0,P<0.05),and SII was negatively correlated with albumin(rs<0,P<0.001).Multivariate Logistic regression analysis showed that RDW,SII and SIS were all independent risk factors for AS(P<0.05).The AUC of the combined detection of the two was 0.734,and the specificity was significantly higher than that of the single index detection(87.3%vs 82.7%,80.9%).Conclusion SII and SIS are independent risk factors of ankylosing spondylitis,and can be used as clinical auxiliary diagnostic indicators.The combined detection of the two can improve the early diagnosis rate of AS.