全身炎症反应指数和预后营养指数在预测极早产儿中重度支气管肺发育不良中的作用
Role of systemic inflammation response index and prognostic nutritional index in the prediction of moderate-to-severe bronchopulmonary dysplasia in very preterm infants.
作者信息
An Ning, Li Jing, Li Mingxia
机构信息
College of Pediatrics, Xinjiang Medical University, Urumqi, China.
Department of Neonatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
出版信息
Transl Pediatr. 2025 Jan 24;14(1):52-60. doi: 10.21037/tp-24-381. Epub 2025 Jan 21.
BACKGROUND
Bronchopulmonary dysplasia (BPD) is a severe chronic lung disease that primarily affects premature infants. BPD usually comes with delayed diagnosis, and the lung injury at the time of confirmed diagnosis is irreversible. The inflammatory response is a crucial pathogenic factor for BPD. The combination of prognostic nutritional index (PNI) and systemic inflammation response index (SIRI) is a comprehensive indicator that can reflect the balance between immune status and host inflammatory response. This study aimed to explore the predictive ability of SIRI and PNI for moderate-to-severe BPD (msBPD) in premature infants.
METHODS
The research involved infants born before 32 weeks of gestational age (GA). The division of patients resulted in two groups: the control group with no or mild BPD and the msBPD group. Relevant data were collected to compare the differences regarding clinical data; SIRI and PNI were calculated within 24 hours after birth and at the time of diagnosis of BPD [at 36 weeks of postmenstrual age (PMA)]. The ability of SIRI and PNI to predict msBPD was evaluated by logistic regression analysis.
RESULTS
A total of 491 infants were included in the study, with 435 infants in the control group and 56 infants in the msBPD group. The msBPD group exhibited lower PNI levels and higher SIRI levels compared to the control group. The area under the curve (AUC) value [95% confidence interval (CI): of SIRI and PNI were 0.599 (0.514-0.685) and 0.588 (0.504-0.672)], and the cut-off values were >1.927 and <34.105, respectively, within 24 hours after birth. The AUC value of SIRI and PNI were 0.602 (0.515-0.689) and 0.647 (0.569-0.725), and the cut-off values were >5.175 and <45.080, respectively, for the diagnosis of BPD at 36 weeks of PMA.
CONCLUSIONS
SIRI and PNI have a certain predictive and diagnostic values for managing msBPD in premature infants.
背景
支气管肺发育不良（BPD）是一种主要影响早产儿的严重慢性肺部疾病。BPD通常诊断延迟，确诊时的肺损伤不可逆转。炎症反应是BPD的关键致病因素。预后营养指数（PNI）与全身炎症反应指数（SIRI）的联合是一种能反映免疫状态与宿主炎症反应之间平衡的综合指标。本研究旨在探讨SIRI和PNI对早产儿中重度BPD（msBPD）的预测能力。
方法
该研究纳入了孕周（GA）小于32周出生的婴儿。将患者分为两组：无BPD或轻度BPD的对照组和msBPD组。收集相关数据以比较临床资料的差异；在出生后24小时内以及BPD诊断时[月经龄（PMA）36周]计算SIRI和PNI。通过逻辑回归分析评估SIRI和PNI预测msBPD的能力。
结果
本研究共纳入491例婴儿，其中对照组435例，msBPD组56例。与对照组相比，msBPD组的PNI水平较低，SIRI水平较高。出生后24小时内，SIRI和PNI的曲线下面积（AUC）值[95%置信区间（CI）]分别为0.599（0.514 - 0.685）和0.588（0.504 - 0.672），截断值分别为>1.927和<34.105。在PMA 36周诊断BPD时，SIRI和PNI的AUC值分别为0.602（0.515 - 0.689）和0.647（0.569 - 0.725），截断值分别为>5.175和<45.080。
结论
SIRI和PNI对管理早产儿msBPD具有一定的预测和诊断价值。
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