全身炎症反应指数(SIRI)与自身免疫性脑炎 发病风险的相关性研究

Association of Systemic Inflammatory Response Index (SIRI) with the Risk of Autoimmune Encephalitis

摘要: 背景：自身免疫性脑炎(AE)是一种严重的神经免疫性疾病，其早期诊断仍面临挑战。本研究旨在探讨全身炎症反应指数(SIRI)、NLR、MLR、PLR与AE发病风险的相关性研究，并评估上述炎症指标对AE的预测价值。方法：共纳入130例AE患者及130例年龄、性别匹配的健康对照人群。采集所有受试者的外周血细胞计数，并计算SIRI、NLR、MLR及PLR。利用多因素logistic回归分析影响AE发病风险的独立危险因素，并通过受试者工作特征(ROC)曲线评估各炎症指标对AE的预测效能。结果：多因素logistic回归分析显示，SIRI是AE发病的独立危险因素(OR = 8.20, 95% CI: 2.08~32.42, p = 0.003)。ROC曲线分析表明，SIRI预测AE的曲线下面积(AUC)为0.797 (95% CI: 0.740~0.854)，最佳临界值为1.073，特异度为93.85%，敏感度为63.08%。NLR也表现出良好的预测价值(AUC = 0.786)，其敏感度为69.92%，特异度为90.77%。MLR与PLR的预测效能相对较低(AUC分别为0.748和0.722)。结论：SIRI是预测AE发病风险的可靠炎症指标，是具有高度特异性的独立危险因素，有助于AE的辅助识别与风险评估。

Abstract: Background: Autoimmune encephalitis (AE) is a severe neuroimmune disorder, and its early diagnosis remains challenging. This study aims to investigate the association between systemic inflammation response index (SIRI), NLR, MLR, PLR, and the risk of AE onset, and to evaluate the predictive value of these inflammatory indicators for AE. Methods: A total of 130 AE patients and 130 age- and gender-matched healthy controls were included in this study. Peripheral blood cell counts were collected from all subjects, and SIRI, NLR, MLR, and PLR were calculated. Multivariate logistic regression analysis was used to identify independent risk factors for AE onset, and the predictive performance of each inflammatory indicator was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Multivariate logistic regression analysis showed that SIRI is an independent risk factor for AE onset (OR = 8.20, 95% CI: 2.08~32.42, p = 0.003). ROC curve analysis indicated that the area under the curve (AUC) for SIRI in predicting AE was 0.797 (95% CI: 0.740~0.854), with an optimal cutoff value of 1.073, specificity of 93.85%, and sensitivity of 63.08%. NLR also demonstrated good predictive value (AUC = 0.786), with a sensitivity of 69.92% and specificity of 90.77%. The predictive performance of MLR and PLR was relatively lower (AUCs of 0.748 and 0.722, respectively). Conclusion: SIRI is a reliable inflammatory indicator for predicting the risk of AE onset, serving as an independent risk factor with high specificity, and can assist in the auxiliary identification and risk assessment of AE.