目的 探讨系统免疫炎症指数(SII)联合血清鸢尾素对肝硬化肌肉减少症的预测价值.方法 选取2020年1月至2023年10月青岛市第八人民医院内科收治的63例肝硬化肌肉减少症患者为肌肉减少症组、183例单纯肝硬化患者为肝硬化组.比较两组SII和检测血清鸢尾素水平.采用多因素logistic回归分析肝硬化肌肉减少症的影响因素,受试者操作特征曲线分析SII联合血清鸢尾素对肝硬化肌肉减少症的预测价值.结果 两组年龄、体重指数、Child-Pugh分级、血红蛋白、总胆红素、血肌酐、终末期肝病模型评分、SII、鸢尾素比较,差异有统计学意义(P＜0.05).多因素logistic回归结果显示,年龄增加(OR=1.087,95％CI:1.005～1.175,P=0.036)、Child-Pugh 分级 B 级(OR=3.348,95％CI:1.047～10.705,P=0.042)、C 级(OR=8.819,95％CI:2.731～28.480,P＜0.001)、SII 升高(OR=1.006,95％CI:1.004～1.009,P＜0.001)为肝硬化肌肉减少症的独立危险因素,体重指数增加(OR=0.797,95％CI:0.679～0.935,P=0.005)、鸢尾素升高(OR=0.980,95％CI:0.971～0.989,P＜0.001)为独立保护因素.SII联合血清鸢尾素预测肝硬化肌肉减少症的曲线下面积为0.908,大于SII、血清鸢尾素单独预测的0.825、0.809(P＜0.05).结论 SII升高和血清鸢尾素降低与肝硬化肌肉减少症密切相关,SII联合血清鸢尾素对肝硬化肌肉减少症有较高的预测价值.
Predictive value of systemic immune-inflammation index combined with serum irisin for cirrhotic sarcopenia
Objective To explore the predictive value of the systemic immune-inflammation index(SII)combined with serum irisin for cirrhotic sarcopenia.Methods A total of 63 patients with cirrhotic sarcopenia as the sarcopenia group,and 183 patients with simple cirrhosis as the cirrhosis group admitted to the Department of Internal Medicine of Qingdao Eighth People's Hospital from January 2020 to October 2023 were selected.SII and serum irisin levels were compared between the two groups.Multivariate logistic regression analysis was used to identify the factors contributing to cirrhosis sarcopenia,and the predictive value of SII combined with serum irisin on cirrhotic sarcopenia was analyzed using receiver operating characteristic curves.Results There were significant differences in age,body mass index,Child-Pugh grade,hemoglobin,total bilirubin,serum creatinine,model for end-stage liver disease score,SII,and irisin between the two groups(P＜0.05).Multivariate logistic regression results showed that age increased(OR=1.087,95％CI:1.005-1.175,P=0.036),Child-Pugh grade B(OR=3.348,95％CI:1.047-10.705,P=0.042),grade C(OR=8.819,95％CI:2.731-28.480,P＜0.001),elevated SII(OR=1.006,95％CI:1.004-1.009,P＜0.001)were independent risk factors for cirrhotic sarcopenia,increased body mass index(OR=0.797,95％CI:0.679-0.935,P=0.005)and elevated irisin(OR=0.980,95％CI:0.971-0.989,P＜0.001)were independent protective factors.The area under the curve predicted by SII combined with serum irisin was 0.908,which was larger than 0.825 and 0.809 predicted by SII and serum irisin alone(P＜0.05).Conclusion The increase of SII and the decrease of serum irisin are closely related to cirrhotic sarcopenia.The combination of SII and serum irisin has high predictive value for cirrhotic sarcopenia.
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