天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (11): 1188-1192.doi: 10.11958/20211164

• 临床研究 • 上一篇    下一篇

系统免疫炎症指数对新型冠状病毒肺炎核酸转阴时间的影响

郭晶,李莉,吴茜,李红蔚,史丽霞,吴琦   

  1. 1天津市海河医院呼吸与危重症医学科、天津市呼吸疾病研究所（邮编300350）；2天津市海河医院医务科；3天津医科大学总医院呼吸与危重症医学科
  • 收稿日期:2021-05-19 修回日期:2021-07-14 出版日期:2021-11-15 发布日期:2021-11-19
  • 基金资助:
    天津市卫生健康新冠肺炎防治科技项目（2020XKZ02）

The effect of the systemic immune-inflammation index on conversion time of virus nucleic acid turning negative in COVID-19 patients

GUO Jing, LI Li, WU Qian, LI Hong-wei, SHI Li-xia, WU Qi   

  1. 1 Department of Respiratory and Critical Care Medicine, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, Tianjin 300350, China, 2 Department of Medical Administration, Tianjin Haihe Hospital; 3 Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital
  • Received:2021-05-19 Revised:2021-07-14 Published:2021-11-15 Online:2021-11-19

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摘要： 目的　探讨系统免疫炎症指数（SII）对新型冠状病毒肺炎（COVID-19）核酸转阴时间的影响。方法　选取接受住院治疗并康复出院的127例COVID-19患者为研究对象，通过电子病历系统收集患者临床资料及入院24 h内的实验室检查结果，根据血常规结果计算SII值并以其中位数将患者分为高SII组（≥393）和低SII组（＜393），比较2组的临床资料及中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、C反应蛋白（CRP）、白细胞介素（IL）-6、白蛋白（ALB）的差异。Cox回归分析确定影响核酸转阴时间的危险因素。Kaplan-Meier法比较不同组患者的核酸转阴曲线。结果　高SII组的男性比例、NLR、PLR、CRP均高于低SII组（P＜0.05）。Cox多因素回归分析显示，发病至入院时间＞5 d、重症、高SII是影响核酸转阴的独立危险因素（P＜0.05）。Kaplan-Meier曲线显示，高SII值、重症、发病至入院时间＞5 d的患者核酸转阴中位时间分别长于低SII值、非重症、发病至入院时间≤5 d的患者，差异均有统计学意义（P＜0.05）。结论　SII是反映机体炎症及免疫状态的综合指标，简单易得，高SII值为COVID-19患者核酸转阴时间延长的独立危险因素。

关键词: 肺炎, 病毒性, 冠状病毒属, 新型冠状病毒肺炎, 新型冠状病毒, 系统免疫炎症指数, 核酸转阴时间

Abstract: Objective　To investigate the effect of the systemic immune-inflammation index (SII) on the conversion time of virus nucleic acid turning negative in patients with coronavirus disease 2019 (COVID-19). Methods　A total of 127 patients were selected who were admitted to our hospital from January to March 2020. Clinical data and laboratory results within 24 hours of admission were obtained from the electronic medical record system. Blood routine results were recorded to calculate SII. According to the median SII, the patients were divided into the high SII group (≥393) and the low SII group (<393). The clinical data, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), interleukin(IL)-6 and albumin (ALB) were compared between the two groups. Cox regression analysis was performed to identify risk factors affecting the negative time of viral nucleic acid. Kaplan-Meier analysis was used to describe the nucleic acid turning negative curve of different groups of patients. Results　The male proportion, NLR, PLR and CRP were higher in the high SII group than those in the low SII group (P＜0.05). Cox multivariate regression analysis showed that severe patients, higher SII and the time from onset to admission > 5 days were independent risk factors affecting the time of nucleic acid negative conversion (P＜0.05). Kaplan-Meier curve showed that the median nucleic acid turning negative time was significantly longer in patients with high SII value, severe disease and time from onset to admission > 5 days than that in patients with low SII value, non-severe disease and time from the onset to admission ≤5 days (P＜0.05). Conclusion　SII is a simple biomarker representing inflammation and the immune response. It can be used as an independent risk factor for prolonged nucleic acid negative conversion time in COVID-19 patients.

Key words: pneumonia, viral, coronavirus, COVID-19, SARS-CoV-2, systemic immune-inflammation index, time of nucleic acid turning negative