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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

29卷

期数:

2023年03期

页码:

295-301

栏目:

临床医学

出版日期:

2023-05-20

文章信息/Info

Title:

Correlation of immune-inflammation index with native liver survival after Kasai surgery for biliary atresia：propensity score matching analysis

文章编号:

1006－8147（2023）03-0295-07

作者:

刘志杰¹; 林峰¹; 王皓洁¹; 李鑫¹; 李梦迪²; 祖力帕尔·雪合热提¹; 阿里木江·阿不都热依木¹

（1.乌鲁木齐市第一人民医院（乌鲁木齐儿童医院）外科，乌鲁木齐 830000；2.天津市儿童医院普通外科，天津300134）

Author(s):

LIU Zhi-jie¹; LIN Feng¹; WANG Hao-jie¹; LI Xin¹; LI Meng-di²;  Zulipaer·Xuehereti¹;  Alimujiang·Abudureyimu¹

（1.Department of General Surgery，Urumqi First People′s Hospital （Urumqi Children′s Hospital），Urumqi 830000，China；2.Department of General Surgery，Tianjin Children′s Hospital，Tianjin 300134，China）

关键词:

免疫炎症指数; 胆道闭锁; Kasai手术; 临床结局; 自体肝生存

Keywords:

systemic immune-inflammation index; biliary atresia; Kasai operation; clinical outcome; native liver survival

分类号:

R726.1+R726.5

DOI:

-

文献标志码:

A

摘要:

目的：探讨胆道闭锁（BA）术前系统性免疫炎症指数（SII）与Kasai术后自体肝生存情况的相关性。方法：收集148例行Kasai术BA患儿临床资料，根据术前化验结果计算SII并二分化处理（低和高SII组），进行倾向性评分匹配（PSM）后运用单因素/多因素回归分析SII水平对术后临床结局的影响。结果：以24个月自体肝生存情况为因变量，利用受试者工作特征曲线（ROC曲线）确定SII高低分组的最佳临界值为143.8。经1∶1 匹配后筛选出低或高SII患者各34例，两组临床资料差异无统计学意义（P＞0.05）。PSM后分析发现，高SII组较低SII组在术后24个月自体肝生存率、黄疸清除及肝功能恢复良好率更低（均P＜0.05）。回归分析显示：高肝纤维化分级（Ⅳ级相对Ⅰ级，OR= 29.894，95%CI：4.393～70.322）、营养不良（OR=28.434，95%CI：3.285～246.109）及术前高SII水平（OR=41.027，95%CI：7.836～214.805）为24个月自体肝未生存的独立危险因素（均P＜0.05）。结论：SII可作为BA患者Kasai术后对临床结局进行评估判断的早期生物指标，并作为独立危险因素影响Kasai术后的自体肝生存时间。

Abstract:

Objective：To investigate the correlation between the preoperative systemic immune-inflammation index（SII） of biliary atresia（BA） and native liver survival after Kasai surgery. Methods：The clinical data of 148 children with BA receiving Kasai operation were collected， and SII was calculated and dichotomized（low and high SII groups） based on preoperative laboratory results. Propensity score matching（PSM） was performed followed by univariate/multi-factor regression to analyze the effect of SII level on postoperative clinical outcomes. Results：Using 24-month native liver survival as the dependent variable， the ROC curve was used to determine the optimal threshold value of 143.8 for the high and low SII groups. Thirty-four patients each with low or high SII were screened after 1：1 matching， and there was no statistical difference in the clinical data between the two groups（P＞0.05）. Post-PSM analysis revealed that the high SII group had lower postoperative 24-month native liver survival， jaundice clearance and good recovery of liver function compared to the low SII group（all P＜0.05）. Regression analysis showed that high liver fibrosis grade（grade Ⅳversus gradeⅠ，OR=29.894，95%CI：4.393-70.322），malnutrition（OR=28.434，95%CI：3.285-246.109） and high preoperative SII level（OR=41.027，95%CI：7.836-214.805） were independent risk factors for 24-month native liver non-survival（all P＜0.05）. Conclusion：SII can be used as an early biological indicator to assess the judgment of clinical outcomes after Kasai in BA patients and as an independent risk factor to influence the time to native liver survival after Kasai operation.

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[7]刘志杰综述,詹江华审校.肝巨噬细胞在胆道闭锁肝纤维化中的作用[J].天津医科大学学报,2023,29(04):453.

备注/Memo

备注/Memo:

基金项目 新疆维吾尔自治区自然科学基金面上项目（2022D01A27）
作者简介 刘志杰（1979-），男，主治医师，硕士在读，研究方向：儿外科学；通信作者：阿里木江·阿不都热依木，E-mail：alm0223@163.com。

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更新日期/Last Update: 1900-01-01