全身性免疫炎症指数及血小板/中性粒细胞与淋巴细胞比值在吉兰-巴雷综合征中的临床意义。
The clinical significance of systemic immune-inflammation index and platelet/neutrophil to lymphocyte ratio in Guillain-Barré syndrome.
机构信息
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China; Institute of Cerebrovascular Diseases, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
出版信息
Clin Neurol Neurosurg. 2023 Dec;235:108015. doi: 10.1016/j.clineuro.2023.108015. Epub 2023 Oct 17.
OBJECTIVE
Systemic immune-inflammation index (SII) and platelet/neutrophil to lymphocyte ratio (P/NLR) are two novel hematological inflammatory indices, this study invested the role of SII and P/NLR in Guillain-Barré syndrome (GBS).
METHODS
A total of 115 GBS patients and 120 healthy controls were enrolled in this retrospective study, SII and P/NLR were calculated from the value of complete blood counts. The Hughes Functional Grading Scale (HFGS) score on admission and at discharge was used to evaluate the severity and short-term outcome of GBS. The level of SII and P/NLR was compared between GBS patients and healthy controls, and the correlation between SII, P/NLR, and GBS's severity as well as poor short-term outcome was analyzed.
RESULTS
Increased SII (p < 0.001) and decreased P/NLR (p < 0.001) were observed in patients with GBS and the level of SII (p = 0.689) and P/NLR (p = 0.879) was not different between GBS subtypes. Patients with severe GBS and poor short-term outcomes had higher levels of SII and lower levels of P/NLR (p < 0.05), SII was positively correlated and P/NLR was negatively correlated with the HFGS score on admission and at discharge (p < 0.05). To predict severe GBS, the optimal cutoff value of SII was 620.87 (AUC0.633, sensitivity 60.8 % and specificity 60.9 %, p = 0.014), the optimal cutoff value of P/NLR was 53.11 (AUC0.635, sensitivity 45.1 %, specificity 82.8 %, p = 0.013). The SII level of 620.87 was found to be optimal predictive cutoff value for the poor short-term outcome of GBS (AUC 0.728, sensitivity of 82.6 %, specificity of 59.8 %, p = 0.001), the P/NLR level of 62.80 was found to be optimal predictive cutoff value for the poor short-term outcome of GBS (AUC 0.669, sensitivity 60.9 %, specificity 71.7 %, p = 0.012). Both SII>620.87 (p = 0.005) and P/NLR<53.11 (p = 0.002) were independent risk factors for severe GBS, and SII>620.87 (p = 0.035) was independently associated with the poor short-term outcome of GBS.
CONCLUSION
SII and P/NLR may be useful biomarkers to reflect GBS patients' severity and short-term outcome.
目的
全身性免疫炎症指数（SII）和血小板/中性粒细胞与淋巴细胞比值（P/NLR）是两种新的血液学炎症指标，本研究探讨了 SII 和 P/NLR 在吉兰-巴雷综合征（GBS）中的作用。
方法
本回顾性研究纳入了 115 例 GBS 患者和 120 例健康对照者，从全血细胞计数中计算 SII 和 P/NLR 值。入院时和出院时采用 Hughes 功能分级量表（HFGS）评分评估 GBS 的严重程度和短期预后。比较 GBS 患者和健康对照组之间 SII 和 P/NLR 的水平，并分析 SII、P/NLR 与 GBS 严重程度和不良短期预后的相关性。
结果
GBS 患者的 SII（p<0.001）升高和 P/NLR（p<0.001）降低，GBS 各亚型之间 SII（p=0.689）和 P/NLR（p=0.879）水平无差异。严重 GBS 和不良短期预后的患者 SII 水平较高，P/NLR 水平较低（p<0.05），SII 与入院和出院时的 HFGS 评分呈正相关，而 P/NLR 与 HFGS 评分呈负相关（p<0.05）。预测严重 GBS 时，SII 的最佳截断值为 620.87（AUC0.633，敏感性 60.8%，特异性 60.9%，p=0.014），P/NLR 的最佳截断值为 53.11（AUC0.635，敏感性 45.1%，特异性 82.8%，p=0.013）。SII 水平为 620.87 时是预测 GBS 不良短期预后的最佳截断值（AUC 0.728，敏感性 82.6%，特异性 59.8%，p=0.001），P/NLR 水平为 62.80 时是预测 GBS 不良短期预后的最佳截断值（AUC 0.669，敏感性 60.9%，特异性 71.7%，p=0.012）。SII>620.87（p=0.005）和 P/NLR<53.11（p=0.002）均是严重 GBS 的独立危险因素，SII>620.87（p=0.035）与 GBS 的不良短期预后相关。
结论
SII 和 P/NLR 可能是反映 GBS 患者严重程度和短期预后的有用生物标志物。
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