溃疡性结肠炎患者PNI与疾病活动性的相关性研究

A Study of the Correlation between PNI and Disease Activity in Patients with UC

摘要: 目的：探讨预后营养指数(prognostic nutritional index, PNI)与溃疡性结肠炎(ulcerative colitis, UC)患者疾病活动度的相关性。方法：回顾性分析2016年9月至2024年5月期间于河北省人民医院首次明确诊断为UC的患者117例。收集患者的基本信息、临床症状、实验室检查及内镜检查等结果。根据改良Mayo评分系统评估患者的疾病活动性。比较不同严重程度UC患者之间PNI、中性粒细胞–淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)、血小板–淋巴细胞比值(platelet to lymphocyte ratio, PLR)、淋巴细胞–单核细胞比值(lymphocyte to monocyte ratio, LMR)、全身免疫炎症指数(systemic immune-inflammation index, SII)的差异，并进行上述指标分别与Mayo评分的相关性分析，应用受试者工作特征(receiver operating characteristic, ROC)曲线评估上述指标对UC活动的预测价值。结果：UC不同严重程度分组之间的PNI存在差异(P < 0.001)。PNI与UC患者Mayo评分呈负相关(P < 0.001)。受试者工作特征曲线分析结果显示，PNI对预测UC严重程度有一定价值，预测中重度活动及重度活动时PNI的最佳截断值分别为47.22、42.00，敏感性分别为81.82%、90.91%，特异性分别为75.00%、82.11%。结论：PNI水平与UC疾病活动性密切相关，可能是用于预测UC疾病活动的潜在指标。

Abstract: Objective: To investigate the correlation between the Prognostic Nutritional Index (PNI) and disease activity in patients with Ulcerative Colitis (UC). Methods: A retrospective analysis was conducted on 117 patients who were first diagnosed with UC at Hebei General Hospital between September 2016 and May 2024. Data collected included patient demographics, clinical manifestations, laboratory tests, and endoscopic findings. Disease activity was assessed using the modified Mayo score. The Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and systemic immune inflammation index (SII) were compared across different severities of UC. Correlations between these biomarkers and Mayo scores were evaluated, and receiver operating characteristic (ROC) curves were generated to assess the predictive value of these indices for UC activity. Results: The differences in PNI across groups with varying disease severities were statistically significant (P < 0.001). Furthermore, PNI demonstrated a negative correlation with Mayo scores (P < 0.001). ROC curve analysis suggested that PNI is a useful predictor of UC severity, with optimal cutoffs of 47.22 and 42.00 for predicting moderate-to-severe and severe disease activity, respectively. The sensitivities at these thresholds were 81.82% and 90.91%, with specificities of 75.00% and 82.11%, respectively. Conclusion: PNI levels are closely related to UC disease activity and may serve as a potential indicator for predicting UC activity.