炎症指标对口腔颌面部间隙感染患者预后的价值研究

The predictive value of inflammatory indicators for the prognosis of patients with oral and maxillofacial space infections

摘要:

目的 评估中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）和全身免疫炎症指数（SII）对口腔颌面部间隙感染（OMSI）患者预后的价值。方法 回顾性分析2021年1月—2024年12月西安交通大学口腔医院收治的255例OMSI患者的临床资料。依据患者是否出现并发症，将其分为有并发症组与无并发症组，分别有191、64例。收集两组治疗前的实验室检查指标及临床资料，并计算NLR、PLR、MLR和SII。比较两组患者的临床资料，采用多因素一般Logistic回归模型分析OMSI患者预后不良的危险因素，应用受试者工作特征（ROC）曲线分析NLR、PLR、MLR和SII对OMSI患者预后不良的预测价值。结果 无并发症组住院天数少于有并发症组（P 0.05），累及间隙数、白蛋白、中性粒细胞、血小板（PLT）、NLR、PLR、MLR和SII均低于有并发症组（P 0.05），血红蛋白、淋巴细胞（LYM）和白蛋白均高于有并发症组（P 0.05）。多因素一般Logistic回归分析结果显示：SII高［O^R =1.001（95% CI：0.097，1.007）］、NLR高［O^R =1.236（95% CI：1.125，1.358）］、PLR高［O^R =1.008（95% CI：1.004，1.013］、LYM低［O^R =0.024（95% CI：0.006，0.102）］及PLT高［O^R =1.016（95% CI：1.010，1.023）］均为OMSI患者发生并发症的危险因素（P 0.05）。ROC曲线分析结果显示，SII水平预测OMSI患者发生并发症的曲线下面积为0.934，敏感性分别为89.1%（95% CI：0.788，0.955），特异性为82.2%（95% CI：0.760，0.873），提示SII在OMSI患者预后评估中具有较高的预测效能。结论 SII与OMSI患者预后密切相关，可作为预测和评估OMSI患者早期病情的严重程度及并发症的指标，其临床效用良好，有助于指导临床决策。

Abstract:

Objective To evaluate the value of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune inflammation index (SII) in the prognosis of patients with oral and maxillofacial space infection (OMSI).Methods A retrospective analysis was conducted on the clinical data of 255 patients with OMSI admitted to the Stomatological Hospital of Xi'an Jiaotong University from January 2021 to December 2024. According to whether the patients had complications, they were divided into complication group and non-complication group. The laboratory test indicators and clinical data before treatment of the two groups were collected, and NLR, PLR, MLR and SII were calculated. The clinical data and laboratory test indicators of the two groups of patients were compared. Logistic regression was used to analyze the risk factors for poor prognosis in OMSI patients, and ROC curve was applied to analyze the predictive value of NLR, PLR, MLR and SII for poor prognosis in OMSI patients.Results There were significant differences in hemoglobin level, neutrophil level, lymphocyte level, platelet level, albumin level, NLR, PLR, MLR and SII between the non-complication group and the complication group (P 0.05). The neutrophil level, platelet level, NLR, PLR, MLR and SII in the non-complication group were lower than those in the complication group (P 0.05), and the hemoglobin level, lymphocyte level and albumin level were higher than those in the complication group (P 0.05). Regression analysis showed that high SII, NLR, PLR, platelet level, and low lymphocyte level were risk factors for complications in OMSI patients (P 0.05). ROC curve analysis showed that the AUC of SII level was 0.934, and its sensitivity and specificity were 89.1% and 82.2%, respectively, suggesting that SII had a high predictive efficiency in the prognosis evaluation of OMSI patients.Conclusion SII is closely related to the prognosis of OMSI patients and can be used as an indicator to predict and evaluate the severity of the early disease and possible complications in OMSI patients. It has good clinical efficacy and is helpful in guiding clinical decision-making.