Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Ankara Etlik Zubeyde Hanim Women's Health Education and Research Hospital, Ankara, Turkey.
Am J Reprod Immunol. 2024 Oct;92(4):e13937. doi: 10.1111/aji.13937.
This study aims to evaluate the effectiveness of inflammation indexes (systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], pan-immune inflammation value [PIV], and neutrophil-to-lymphocyte ratio [NLR]) in the diagnosis of intrahepatic cholestasis of pregnancy (ICP).
A retrospective study was conducted, reviewing medical records of patients diagnosed with ICP who delivered between October 1, 2022, and May 31, 2023, at the Perinatology clinic of Etlik City Hospital, Ankara. A control group of healthy pregnant women with uncomplicated pregnancies was also included. Demographic data, clinical characteristics, and laboratory results, including systemic inflammation indices and liver enzyme levels, were collected and analyzed.
A total of 242 participants were included, with 121 ICP patients and 121 controls. White blood cell count, neutrophil count, and monocyte count showed significant differences between the two groups (p = 0.011, p = 0.004, and p = 0.039, respectively). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly elevated in the ICP group (p < 0.001 for both). SII and NLR were higher in the ICP group compared to controls (p = 0.032 and p = 0.010, respectively). Receiver operating characteristic (ROC) analysis revealed moderate predictive values for SII (area under the curve [AUC] = 0.581, p = 0.030) and NLR (AUC = 0.598, p = 0.009), with no significant difference in their predictive power (p = 0.502).
Systemic inflammation indices such as SII and NLR offer a cost-effective and rapid means of diagnosing ICP, potentially complementing or surpassing traditional biomarkers like bile acid levels and liver function tests (LFTs). These indices can be easily integrated into routine clinical practice, providing timely intervention to improve maternal and fetal outcomes. Further research is warranted to confirm these findings and establish standardized protocols for their use in ICP management.
本研究旨在评估炎症指标（全身免疫炎症指数[SII]、全身炎症反应指数[SIRI]、泛免疫炎症值[PIV]和中性粒细胞与淋巴细胞比值[NLR]）在妊娠肝内胆汁淤积症（ICP）诊断中的有效性。
这是一项回顾性研究，对 2022 年 10 月 1 日至 2023 年 5 月 31 日期间在安卡拉 Etlik 市医院围产医学诊所分娩的 ICP 患者的病历进行了回顾。还纳入了一组患有无并发症妊娠的健康孕妇作为对照组。收集并分析了人口统计学数据、临床特征以及包括全身炎症指标和肝功能酶水平在内的实验室结果。
共纳入 242 名参与者，其中 ICP 患者 121 例，对照组 121 例。两组间白细胞计数、中性粒细胞计数和单核细胞计数存在显著差异（p = 0.011、p = 0.004 和 p = 0.039）。天冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）水平在 ICP 组显著升高（均 p < 0.001）。与对照组相比，ICP 组的 SII 和 NLR 更高（p = 0.032 和 p = 0.010）。受试者工作特征（ROC）分析显示，SII（曲线下面积[AUC] = 0.581，p = 0.030）和 NLR（AUC = 0.598，p = 0.009）具有中等的预测价值，且预测能力无显著差异（p = 0.502）。
SII 和 NLR 等全身炎症指标为诊断 ICP 提供了一种经济有效的快速方法，可能补充或超越胆汁酸水平和肝功能检查（LFT）等传统生物标志物。这些指标可以很容易地整合到常规临床实践中，以便及时进行干预，从而改善母婴结局。需要进一步的研究来证实这些发现，并为其在 ICP 管理中的应用建立标准化方案。
