Han Winn Hui, Tshung En Wong Tobias, Yusof Ruhana Che, Choong Rebecca Kai Jan, Yong Shin Shen, Faheem Nik Aimee Azizah, Kwan Zhenli
Division of Dermatology, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia.
Clin Exp Dermatol. 2024 Dec 23;50(1):141-145. doi: 10.1093/ced/llae332.
Inflammatory markers such as neutrophil-lymphocyte ratio (NLR) and eosinophil count are known prognostic indicators for the severity of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). This study explores the correlation of systemic immune-inflammation index (SII), platelet-lymphocyte ratio (PLR) and NLR with Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) and patient outcomes. A retrospective audit of 34 patients with SJS/TEN (25 SJS, 3 SJS/TEN overlap, 6 TEN) was conducted from 2018 to 2022. Mean admission values were SII 1597 (SD 1904), NLR 6.52 (SD 5.99) and PLR 202 (SD 135). Cut-off values for predicting mortality were SII 1238 [area under receiver operating characteristic curve (AUROC) 0.82], NLR 8.32 (AUROC 0.80) and PLR 285 (AUROC 0.78). Multiple logistic regression using a backward stepwise method identified SCORTEN as a significant factor associated with mortality (P = 0.03) after adjusting for SII, NLR and PLR. None of the inflammatory markers significantly predicted mortality, although PLR at admission may be a potential risk factor (P = 0.05).
中性粒细胞与淋巴细胞比值（NLR）和嗜酸性粒细胞计数等炎症标志物是已知的史蒂文斯-约翰逊综合征（SJS）/中毒性表皮坏死松解症（TEN）严重程度的预后指标。本研究探讨全身免疫炎症指数（SII）、血小板与淋巴细胞比值（PLR）和NLR与中毒性表皮坏死松解症疾病严重程度评分（SCORTEN）及患者预后的相关性。对2018年至2022年期间34例SJS/TEN患者（25例SJS、3例SJS/TEN重叠、6例TEN）进行了回顾性分析。入院时的平均数值为：SII 1597（标准差1904）、NLR 6.52（标准差5.99）和PLR 202（标准差135）。预测死亡率的临界值为：SII 1238[受试者工作特征曲线下面积（AUROC）0.82]、NLR 8.32（AUROC 0.80）和PLR 285（AUROC 0.78）。采用向后逐步法进行多因素logistic回归分析，在校正SII、NLR和PLR后，确定SCORTEN是与死亡率相关的显著因素（P = 0.03）。尽管入院时的PLR可能是一个潜在危险因素（P = 0.05），但这些炎症标志物均未显著预测死亡率。
