全身免疫炎症指数评估首发精神分裂症患者症状严重程度和认知功能的价值

The value of systemic immune inflammation index in evaluating symptom severity and cognitive function in first-episode schizophrenia patients

目的探讨全身免疫炎症指数(SII)评估首发精神分裂症患者症状严重程度和认知功能的价值。方法选取130例首发精神分裂症患者(研究组)和60例健康志愿者(对照组)。采用阳性与阴性症状量表(PANSS)评估精神病症状的严重程度,用MATRICS公认认知成套测验(MCCB)评估认知功能。检测血小板计数(PLT)、中性粒细胞计数(NC)、淋巴细胞计数(LC),SII=PLT×NC/LC。受试者工作特征曲线(ROC)分析SII诊断精神分裂症的价值,计算曲线下面积(AUC)、灵敏度和特异度;Pearson分析SII与患者症状及认知功能的关系。结果研究组NC和SII水平均高于对照组(P<0.01),而PLT水平低于对照组(P<0.001)。回归分析结果显示,SII是首发精神分裂症发生的独立影响因素(P<0.001)。SII诊断首发精神分裂症的AUC为0.900,灵敏度和特异度分别为0.897、0.783。研究组MCCB信息处理加工速度、注意警觉性、工作记忆、推理问题解决和社会认知评分均低于对照组(P<0.01)。SII水平与PANSS总分及阴性症状评分均呈正相关(P<0.05),与MCCB信息处理加工速度、注意警觉性、社会认知评分均呈负相关(P<0.05)。结论SII对评估首发精神分裂症症状严重程度和认知功能有一定价值。SII越高,精神病症状越重,认知功能越差。

Objective To explore the value of the systemic immune inflammation index(SII)in evaluating the severity of symptoms and cognitive function in first-episode schizophrenia patients.Methods A total of 130 patients with first-episode schizophrenia(study group)and 60 healthy volunteers(control group)were selected and assessed with Positive and Negative Syndrome Scale(PANSS)and MATRICS Consensus Cognitive Battery(MCCB)for the severity of psychiatric symptoms and cognitive function respectively.Levels of platelet count(PLT),neutrophil count(NC)and lymphocyte count(LC)were detected,and SII=PLT×NC/LC.The value of SII in the diagnosis of first-episode schizophrenia was analyzed through the receiver operating characteristic curve(ROC),and the area under the curve(AUC),sensitivity and specificity were calculated.Pearson analysis was used to analyze the relationship among SII,symptom severity and cognitive function.Results The levels of NC and SII in study group were all higher than those in control group(P<0.01),and the level of PLT in study group was lower than that in control group(P<0.001).Regression analysis showed that SII was the independent influence factor for first-episode schizophrenia(P<0.001).The AUC of SII diagnosing first-episode schizophrenia was 0.900,with sensitivity and specificity of 0.897 and 0.783,respectively.Compared with control group,the study group had lower scores in information processing speed,attention alertness,working memory,reasoning problem solving and social cognition of MCCB(P<0.01).SII was positively correlated with the total score and negative symptom score of PANSS(P<0.05),and negatively correlated with factor scores of information processing speed,attention alertness,and social cognition of MCCB(P<0.05).Conclusion SII has certain values in evaluating the symptom severity and cognitive function in patients with first-episode schizophrenia.Higher SII indicates more severe psychiatric symptoms and worse cognitive function.