通讯作者: 陈琨, 13957970707@sina.com

DOI：10.12201/bmr.202410.00070

The value of systemic inflammatory response index, lactate dehydrogenase and glutamic oxalacetic transaminase in identifying the high-risk population of adult fulminant myocarditis

• 摘要：【摘要】目的:评估系统性炎症反应指数(systemic inflammatory response index,SIRI)、乳酸脱氢酶(lactic dehydrogenase,LDH)及谷草转氨酶(glutamic oxalacetic transaminase,GOT)用于识别成人暴发性心肌炎高危人群的价值。方法:收集金华市中心医院2018年1月至2023年12月收治的131例成人心肌炎患者的临床资料,根据病情严重程度将患者分成暴发性心肌炎组和非暴发性心肌炎组,比较两组患者间入院时白细胞计数(white blood cell count,WBC)、嗜中性粒细胞计数(neutrophil count,N)、单核细胞计数(Monocyte count,M)、淋巴细胞计数(lymphocyte count,L)、血小板计数(platelet count,PLT)、SIRI、C反应蛋白(C-reactive protein,CRP)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(Creatine Kinase Isoenzyme,CK-MB)、LDH、GOT、心肌肌钙蛋白I(cardiac troponin I,cTn I)的差异,并使用受试者工作特征曲线(receiver operating characteristic curve,简称ROC曲线)和多因素logistic回归对差异有统计学意义的指标进行分析。结果:非暴发性心肌炎组患者入院时的WBC、N、L、SIRI、CRP、CK、CK-MB、LDH、GOT、cTnI均低于暴发性心肌炎组,且差异有统计学意义(P＜0.05)；经ROC曲线分析差异指标的预测效果,发现LDH和GOT的预测效果较佳(LDH:AUC 0.919、95%CI 0.87-0.97、P＜0.001和GOT:AUC 0.912、95%CI 0.86-0.97、P＜0.001),灵敏度为LDH 75.5%和GOT 84.9%,特异度为LDH 97.3%和GOT 90.4%；经多因素 Logistic 回归分析差异指标,发现LDH＞633 U/L、GOT＞80.45 U/L、SIRI＞2.595×109/L是心肌炎患者发展成暴发性心肌炎的高危因素(LDH:OR 63.156、P=0.001；GOT:OR 18.844、P＜0.001；SIRI:OR 8.326、P=0.005)。结论:心肌炎发病早期,根据患者的SIRI(＞2.595×109/L)、LDH(＞633 U/L)及GOT(＞80.45 U/L)识别成人暴发性心肌炎的高危人群有一定的参考价值。

  关键词： 系统性炎症反应指数；乳酸脱氢酶；谷草转氨酶；成人暴发性心肌炎；高危人群

   

  Abstract: 【Abstract】Objective Evaluate the value of systemic inflammatory response index(SIRI), lactate dehydrogenase(LDH) and glutamic oxalacetic transaminase(GOT) which is used to identify the high-risk population of adult fulminant myocarditis. Methods The clinical data of 131 adult patients with myocarditis collected from Jinhua City Central Hospital between January 2018 and December 2023 were categorized based on illness severity into a fulminant myocarditis group and a non-fulminant myocarditis group. A comparison was conducted between the two groups of patients in terms of white blood cell count (WBC),neutrophil count (N),Monocyte count (M), lymphocyte count (L), platelet count (PLT), SIRI, c-reactive protein (CRP), creatine kinase (CK), creatine kinase Isoenzyme (CK-MB), LDH, GOT, cardiac troponin I (cTn I) upon admission. The receiver operating characteristic curve (ROC) and multivariate logistic regression was utilized to analyze the statistically significant variables between the two groups.Results Upon admission, patients in the non-fulminant myocarditis group exhibited significantly lower levels of WBC, N, L, SIRI, CRP, CK, CK-MB, LDH, GOT, and cTn I compared to those in the fulminant myocarditis group, with statistical significance (P < 0.05).Through ROC curve analysis, it was determined that the predicted effect of LDH and GOT was superior (LDH: AUC 0.919, 95% CI 0.87 to 0.97, P < 0.001 and GOT: AUC 0.912, 95% CI 0.86 to 0.97, P < 0.001). The sensitivity of LDH and GOT was found to be 75.5% and 84.9%, respectively, with corresponding specificity levels of 97.3% and 90.4%.The results of the multivariate logistic regression analysis indicated that elevated levels of LDH (>633 U/L), GOT (>80.45 U/L), and SIRI (>2.595×109/L) were identified as significant risk factors associated with the development of fulminant myocarditis in patients with myocarditis. Specifically, LDH had an odds ratio (OR) of 63.156 with a p-value of 0.001, GOT had an OR of 18.844 with a p-value of less than 0.001, and SIRI had an OR of 8.326 with a p-value of 0.005.

  Key words: systemic inflammatory response index；lactate dehydrogenase；glutamic oxalacetic transaminase；adult fulminant myocarditis；high-risk population

  提交时间：2024-10-28

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• 序号	提交日期	编号	操作
  1	2024-06-20	bmr.202410.00070V1	下载

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