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汤杰, 赵文生, 黄文海, 等. 全身免疫炎症指数对急慢性胆囊炎的鉴别价值[J]. 中国临床医学, 2024, 31(3): 484-490. DOI: 10.12025/j.issn.1008-6358.2024.20240128
引用本文: 汤杰, 赵文生, 黄文海, 等. 全身免疫炎症指数对急慢性胆囊炎的鉴别价值[J]. 中国临床医学, 2024, 31(3): 484-490. DOI: 10.12025/j.issn.1008-6358.2024.20240128
TANG Jie, ZHAO Wensheng, HUANG Wenhai, et al. Value of systemic immune-inflammation index distinguishing acute cholecystitis from chronic cholecystitis[J]. Chinese Journal of Clinical Medicine, 2024, 31(3): 484-490. DOI: 10.12025/j.issn.1008-6358.2024.20240128
Citation: TANG Jie, ZHAO Wensheng, HUANG Wenhai, et al. Value of systemic immune-inflammation index distinguishing acute cholecystitis from chronic cholecystitis[J]. Chinese Journal of Clinical Medicine, 2024, 31(3): 484-490. DOI: 10.12025/j.issn.1008-6358.2024.20240128

全身免疫炎症指数对急慢性胆囊炎的鉴别价值

Value of systemic immune-inflammation index distinguishing acute cholecystitis from chronic cholecystitis

  • 摘要:
    目的 探讨术前全身免疫炎症指数(systemic immune-inflammation index, SII)对急慢性胆囊炎的鉴别价值。
    方法 选择2020年8月至2023年11月于复旦大学附属金山医院行胆囊切除术的胆囊炎患者297例,分为急性胆囊炎组(n=192)和慢性胆囊炎组(n=105),将急性胆囊炎组分为重度亚组(n=114)和轻度亚组(n=78)。采用ROC曲线评估SII和中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)对急慢性胆囊炎的鉴别价值。
    结果 与慢性胆囊炎组相比,急性胆囊炎组男性多,年龄大,高血压合并者比例高,引流量多,引流时间、住院时间、手术时长均延长,白细胞计数、中性粒细胞数、单核细胞数增加,总胆红素、直接胆红素、肌酐水平升高,SII和NLR升高(P<0.05)。与重度亚组相比,轻度亚组引流量减少,引流时间、住院时间、手术时长均缩短,白细胞计数、中性粒细胞数、单核细胞数减少,总胆红素水平降低,淋巴细胞数增加,SII和NLR降低(P<0.05)。SII和NLR鉴别急性胆囊炎的最佳截断值为797.96和3.65,AUC为0.847和0.869,灵敏度为73.2%和74.2%,特异度为86.7%和89.5%;SII和NLR鉴别急性重度胆囊炎的最佳截断值分别为1 056.59和4.65,AUC为0.768和0.779,灵敏度为77.0%和82.3%,特异度为67.5%和62.3%。SII与NLR鉴别急性胆囊炎和急性重度胆囊炎的效能差异无统计学意义。
    结论 SII是一种良好的鉴别急慢性胆囊炎的血液学指标,与NLR鉴别能力相似。

     

    Abstract:
    Objective To explore the value of systemic immune-inflammation index (SII) in differentiating acute and chronic cholecystitis.
    Methods A total of 297 patients with cholecystitis who underwent cholecystectomy in Jinshan Hospital, Fudan University from August 2020 to November 2023 were selected, and were divided into acute cholecystitis group (n=192) and chronic cholecystitis group (n=105). The patients in acute cholecystitis group were further divided into severe subgroup (n=114) and mild subgroup (n=78). The differential diagnosis values of SII and neutrophil-to-lymphocyte ratio (NLR) in acute and chronic cholecystitis were evaluated by ROC curve.
    Results Compared with chronic cholecystitis group, males were more, older, the incidence of hypertension was higher, drainage volume increased, drainage time, hospital time, and surgical duration were all longer, blood cells, neutrophil count, monocyte count increased, total bilirubin, direct bilirubin, and creatinine were higher, SII and NLR increased in the acute cholecystitis group (P<0.05). Compared with the severe subgroup, the drainage volume decreased, drainage time, hospital stay, and surgical duration were shorter, white blood cell count, neutrophil count, monocyte count, and total bilirubin decreased, while lymphocyte count increased, SII and NLR decreased in the mild subgroup (P<0.05). The optimal cutoff values of SII and NLR for distinguishing acute cholecystitis from chronic cholecystitis were 797.96 and 3.65, and the AUC were 0.847 and 0.869, with 73.2% and 74.2% of sensitivity, and 86.7% and 89.5% of specificity. The optimal cutoff values of SII and NLR for distinguishing acute severe cholecystitis from mild cholecystitis were 1 056.59 and 4.65, the AUC were 0.768 and 0.779, with 77.0% and 82.3% of sensitivity, and 67.5% and 62.3% of specificity. There was no statistically significant difference between the values of SII and NLR for distinguishing acute severe and acute cholecystitis.
    Conclusion SII is a good hematological indicator for distinguishing acute cholecystitis from chronic cholecystitis with similar value to NLR.

     

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