通讯作者: 杨东, 280041273@163.com

DOI：10.12201/bmr.202602.00028

Analysis of Risk Factors for Liver Damage Caused by Influenza and Its Correlation with Serum NLR and SII Levels

• 摘要：目的:探讨流行性感冒患者相关肝损害发生的危险因素及其与血清新型炎症标记物NLR、SII水平的相关性。方法:通过医院电子病历系统,收集2018年1月1日-2022年03月31日于本院感染性疾病科住院治疗的流行性感冒成年住院患者的临床资料,包括患者性别,年龄,发病时间至确诊时间,流感类型,体温峰值,实验室检查等,根据是否合并肝损害将患者分为肝功能异常组与肝功能正常组,比较2组患者的临床特征,对其进行统计分析,将差异有统计学意义的指标纳入多因素Logistic回归分析,分析流感患者发生肝功能损害的危险因素,采用相关性分析,分析血清新型炎症标记物NLR、SII与流感患者并发肝损害的相关性。结果:共有251例患者纳入本研究,其中肝功能正常组192例,肝功能异常组59例,肝损伤异常率为23.5%,其中总胆红素升高2例,谷丙转氨酶升高37例,谷草转氨酶升高23例,谷氨酰转肽酶升高41例,碱性磷酸酶升高6例。单因素结果分析显示,肝功能异常组中男性、年龄、中性粒细胞计数、中性粒细胞百分比、乳酸脱氢酶、肌酐、NLR(中性粒细胞计数/淋巴细胞计数)、SII(血小板计数×中性粒细胞计数／淋巴细胞计数)均高于肝功能正常组,差异均有统计学意义(P< 0. 05),将上述变量纳入多因素Logistic回归分析,结果显示,男性(OR=5.238,95%CI:2.460~11.153,P< 0.001)、乳酸脱氢酶(OR=1.014,95%CI:1.008~1.019,P< 0.001)是流行性感冒相关肝功能损害的独立危险因素。ROC曲线分析显示,乳酸脱氢酶的曲线下面积为0.724。流感患者NLR、SII指标均与肝损害呈正相关(r=0.170,r=0.129,P< 0. 05)。结论:男性、乳酸脱氢酶升高为流感患者发生肝损害的危险因素,且NLR、SII与流感患者肝损害呈正相关,可能会成为预测或诊断流感患者合并肝损害的潜在标志物。

  关键词： 流行性感冒 肝损害 危险因素 NLR SII; ; ; ; 

   

  Abstract: Objective To investigate the risk factors for influenza-associated liver injury and its correlation with novel serum inflammatory markers, the neutrophil-to-lymphocyte ratio (NLR) and systemic immune inflammation index (SII). Methods Clinical data from adult influenza inpatients admitted to the Department of Infectious Diseases between January 1, 2018, and March 31, 2022, were retrospectively collected via the hospital electronic medical record system. Parameters included gender, age, time from symptom onset to diagnosis, influenza type, peak body temperature, and laboratory findings. Patients were stratified into liver dysfunction (n=59) and normal liver function (n=192) groups. Statistical analyses compared clinical characteristics between groups. Variables with significant differences in univariate analysis were incorporated into multivariate logistic regression to identify risk factors. Correlation analysis assessed relationships between NLR/SII and liver injury. Results Among 251 enrolled patients, the incidence of liver injury was 23.5% (59/251), manifested as elevated gammaglutamy transferase (GGT, n=41), alanine aminotransferase (ALT, n=37), aspartate aminotransferase (AST, n=23), alkaline phosphatase (ALP, n=6), and total bilirubin (n=2). Univariate analysis revealed significantly higher levels of male proportion, age, neutrophil count, neutrophil percentage, lactate dehydrogenase (LDH), creatinine, NLR, and SII in the liver dysfunction group (all P<0.05). Multivariate analysis identified male gender (OR=5.238, 95%CI:2.460–11.153, P<0.001) and elevated LDH (OR=1.014, 95%CI:1.008–1.019, P<0.001) as independent risk factors. ROC curve analysis showed an AUC of 0.724 for LDH in predicting liver injury. Both NLR and SII exhibited positive correlations with liver injury (r=0.170, P<0.05; r=0.129, P<0.05). Conclusion Male gender and elevated LDH are risk factors for influenza-associated liver injury. NLR and SII demonstrate positive correlations with liver damage, suggesting their potential as predictive biomarkers for influenza-related hepatic complications.

  Key words: Influenza; Hepatic injury; Risk factors; NLR; SII

  提交时间：2026-02-09

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• 序号	提交日期	编号	操作
  1	2025-12-03	10.12201/bmr.202602.00028V1	下载

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