目的:探讨全身免疫炎症指数(SII)和全身炎症反应指数(SIRI)对早孕流产的预测价值。
方法:本回顾性分析共纳入535名个体。早期妊娠丢失(EPL)组包括18-35岁之间经历EPL的患者。对照组包括分娩≥37周的健康孕妇。
结果:EPL组的血小板压裂率明显降低(p=0.04),血小板分布宽度(PDW,p<0.0001),和RDW(p<0.0001)以及高于对照组的单核细胞(p<0.0001)和SIRI(p<0.0001)值。血红蛋白,白细胞,血小板计数,中性粒细胞计数,淋巴细胞计数,平均血小板体积,中性粒细胞与淋巴细胞比率(NLR),血小板与淋巴细胞比率(PLR),单核细胞与淋巴细胞比率(MLR),和SII值在EPL组和对照组之间没有显着差异(p>0.05)。在受试者工作特征曲线中,提供最佳灵敏度/特异性平衡的SIRI的临界值为1.48(灵敏度为63%;特异性为63%)。在预测EPL的炎症参数中,PDW的特异性最高(84%),RDW的灵敏度最高(80%)。
结论:这项研究提供了令人信服的证据,表明各种炎症途径可能显著促进EPL发病机制。此外,我们的研究结果表明,SIRI可能是比NLR更有效的标记,PLR,MLR,和SII预测正在怀孕的EPL,从而可能彻底改变早期妊娠丢失诊断。
OBJECTIVE: To uncover the predictive value of systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI) on early pregnancy loss.
METHODS: A total of 535 individuals were enrolled in this retrospective analysis. The early pregnancy losses (EPL) group included patients between 18-35 years old who experienced EPL. The control group comprised healthy pregnant women who gave birth at ≥37 weeks.
RESULTS: The EPL group had significantly lower plateletcrit (p=0.04), platelet distribution width (PDW, p<0.0001), and RDW (p<0.0001) and higher monocyte (p<0.0001) and SIRI (p<0.0001) values than the control group. The hemoglobin, white blood cells, platelet count, neutrophil count, lymphocyte count, mean platelet volume, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and SII values were not significantly different between the EPL and control groups (p>0.05). The cut-off value for the SIRI that offers the best sensitivity/specificity balance was 1.48 (sensitivity of 63%; specificity of 63%) in the receiver operating characteristics curve. Among the inflammatory parameters for predicting EPL, PDW had highest specificity (84%), and RDW had the highest sensitivity (80%).
CONCLUSIONS: This study provides compelling evidence that various inflammatory pathways may significantly contribute to EPL pathogenesis. Moreover, our findings suggest that SIRI could be a more effective marker than NLR, PLR, MLR, and SII in predicting EPL in an ongoing pregnancy, thereby potentially revolutionizing early pregnancy loss diagnostics.