外周炎症指标与青少年精神障碍患者非自杀性自伤行为的相关性:一项倾向性评分匹配分析

Association between peripheral inflammation index and Non-suicidal Self-injury in Adolescents with Mental disorders:a Propensity Score Matching Analysis

目的探索外周炎症炎性指标与青少年精神障碍患者非自杀性自伤(non-suicidal selfinjury,NSSI)行为的相关性。方法本研究选取中山市第三人民医院2021年5月~2022年4月期间就诊的青少年精神障碍患者,依据是否伴有NSSI行为,将患者区分为NSSI及非NSSI两组。采用倾向性评分匹配(Propensity Score Matching,PSM)进行NSSI组与非NSSI组的1:1倾向性评分匹配,比较PSM成功后两组患者外周血中超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP),中性粒细胞淋巴细胞比例(neutrophil-to-lymphocyte ratio,NLR)的水平差异,并对比不同炎性学参数对于NSSI行为的预测效能。结果本研究共选取了150名患者,其中93例诊断为NSSI。PSM后,NSSI组和非NSSI组各有37例患者,两组社会人口学及心理学方面的基线达到平衡。NSSI组患者NLR,hs-CRP均显著高于非NSSI组(P<0.05);其中hs-CRP的曲线下面积更大(AUC=0.891),预测效能最佳。结论NLR,hs-CRP,等外周炎症指标与青少年精神障碍患者非自杀性自伤行为的发生存在显著相关性,其中hs-CRP对于NSSI行为的预测效能最佳,为早识别,早干预NSSI行为的提供临床依据。

Objective To explore the association between inflammatory markers,and non-suicidal self-injury(NSSI)behavior in adolescents with mental disorders.Methods This study employed adolescents with mental disorders who visited the Third People's Hospital of Zhongshan City from May 2021 to April 2022.Based on the presence or absence of NSSI behavior,the patients were divided into NSSI and non-NSSI groups.Propensity score matching(PSM)was used to perform a 1:1 matching of the NSSI and non-NSSI groups.The differences in level of hs-CRP,and neutrophil-to-lymphocyte ratio(NLR),in peripheral blood between the two groups after successful PSM matching,and the predictive efficacy of different inflammatory parameters for NSSI behavior was evaluated.Results A total of 150 patients were included in this study,with 93 diagnosed with NSSI.After PSM matching,there were 37 patients in both the NSSI and non-NSSI groups,and the baseline sociodemographic and psychological characteristics were balanced between the two groups.The NLR and hs-CRP levels were significantly higher in the NSSI group compared to the non-NSSI group(P<0.05).Among these markers,hs-CRP had the largest area under the curve(AUC=0.891)and the best predictive efficacy.Conclusion Inflammatory markers such as NLR,hs-CRP is significantly associated with the occurrence of NSSI behavior in adolescents with mental disorders.Among these markers,hs-CRP has the best predictive efficacy for NSSI behavior,providing clinical evidence for early identification and intervention of NSSI behavior.