Predictive value of systemic immune-inflammation index and prognostic nutrition index in preterm infants with early-onset sepsis
庞玉冰 1仝子凡 1刘文强 1徐艳 1王军 1林楠
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作者信息
1. 徐州医科大学附属医院新生儿科 221000
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摘要
目的 探讨全身免疫炎症系数（SII）及预后营养指数（PNI）对早产儿早发型败血症（EOS）的预测能力。 方法 选取2019年1月至2022年12月于徐州医科大学附属医院出生，并于1 h内转入新生儿重症监护室，符合EOS诊断标准的28～32周早产儿作为EOS组，1∶1匹配同期住院的非感染早产儿作为对照组，收集相关资料，比较两组间临床资料、血常规相关指标、C-反应蛋白（CRP）、血清白蛋白水平（ALB）及SII、PNI的差异，采用Logistic回归分析及绘制受试者工作特征（ROC）曲线评价SII及PNI预测EOS的能力。 结果 与对照组相比，EOS组患儿1 min及5 min Apgar评分更低，剖宫产娩出及气管插管的比例更高，化脓性脑膜炎、支气管肺发育不良、早产儿视网膜病变及颅内出血的发生率更高；EOS组血常规WBC、ALB、SII和PNI水平较对照组降低，CRP升高；差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示，气管插管、CRP、SII及PNI是EOS的独立影响因素（P<0.05）。ROC曲线分析显示，SII、PNI、CRP、SII联合PNI的曲线下面积分别为0.808（95%CI 0.730~0.886）、0.792（95%CI 0.718~0.865）、0.633（95%CI 0.541~0.725）、0.866（95%CI 0.803~0.929），灵敏度分别为74.3%、64.3%、42.9%、78.6%，特异度分别为88.6%、82.9%、81.4%、90.0%，SII、PNI、CRP的临界值分别为221.36、38.65、0.80 mg/L。 结论 SII、PNI对早产儿EOS具有一定的预测价值，且两者联合预测效能更强。 Objective To explore the predictive ability of systemic immune-inflammation index（SII）and prognostic nutrition index（PNI）for early-onset sepsis in preterm infants. Methods Seventy preterm infants of 28 to 32 weeks，who were born in the Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2022, and transferred to neonatal intensive care unit within 1 h conforming to EOS diagnostic criteria were selected as the EOS group，and 1∶1 matched non-infected preterm infants hospitalized during the same period were selected as control group.Relevant data were collected to compare the differences regarding clinical data，blood routine indicators，C-reactive protein（CRP），serum albumin levels（ALB），SII and PNI between two groups.The ability of SII and PNI to predict EOS was evaluated by Logistic regression analysis and receiver operating characteristic（ROC）curve. Results Compared with control group,the EOS group had lower 1-minute and 5-minute Apgar scores,higher rates of cesarean section delivery and tracheal intubation,as well as higher rates of suppurative meningitis,bronchopulmonary dysplasia,retinopathy of prematurity and intracranial hemorrhage.The levels of blood routine parameters,ALB,SII and PNI in the EOS group were lower than those in control group,while CRP was increased.The differences were all statistically significant（P<0.05）.Multivariate Logistic regression analysis showed that tracheal intubation，CRP，SII and PNI were independently influential factors of EOS（P<0.05）.ROC curve analysis showed that the areas under curve of SII，PNI，CRP and SII combined with PNI were 0.808（95%CI 0.730-0.886），0.792（95%CI 0.718-0.865），0.633（95%CI 0.541-0.725）and 0.866（95%CI 0.803-0.929），the sensitivity were 74.3%，64.3%，42.9%，78.6%，and the specificity were 88.6%，82.9%，81.4%，90.0%,respectively.The cut-off values of SII，PNI and CRP were 221.36，38.65 and 0.80 mg/L,respectively. Conclusion SII and PNI have a certain predictive value for EOS in preterm infants，and their combined diagnosis efficiency is more stronger.
Abstract
Objective To explore the predictive ability of systemic immune-inflammation index（SII）and prognostic nutrition index（PNI）for early-onset sepsis in preterm infants. Methods Seventy preterm infants of 28 to 32 weeks，who were born in the Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2022, and transferred to neonatal intensive care unit within 1 h conforming to EOS diagnostic criteria were selected as the EOS group，and 1∶1 matched non-infected preterm infants hospitalized during the same period were selected as control group.Relevant data were collected to compare the differences regarding clinical data，blood routine indicators，C-reactive protein（CRP），serum albumin levels（ALB），SII and PNI between two groups.The ability of SII and PNI to predict EOS was evaluated by Logistic regression analysis and receiver operating characteristic（ROC）curve. Results Compared with control group,the EOS group had lower 1-minute and 5-minute Apgar scores,higher rates of cesarean section delivery and tracheal intubation,as well as higher rates of suppurative meningitis,bronchopulmonary dysplasia,retinopathy of prematurity and intracranial hemorrhage.The levels of blood routine parameters,ALB,SII and PNI in the EOS group were lower than those in control group,while CRP was increased.The differences were all statistically significant（P<0.05）.Multivariate Logistic regression analysis showed that tracheal intubation，CRP，SII and PNI were independently influential factors of EOS（P<0.05）.ROC curve analysis showed that the areas under curve of SII，PNI，CRP and SII combined with PNI were 0.808（95%CI 0.730-0.886），0.792（95%CI 0.718-0.865），0.633（95%CI 0.541-0.725）and 0.866（95%CI 0.803-0.929），the sensitivity were 74.3%，64.3%，42.9%，78.6%，and the specificity were 88.6%，82.9%，81.4%，90.0%,respectively.The cut-off values of SII，PNI and CRP were 221.36，38.65 and 0.80 mg/L,respectively. Conclusion SII and PNI have a certain predictive value for EOS in preterm infants，and their combined diagnosis efficiency is more stronger.
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