自身免疫性肝炎患者ALP/PLT比值和系统免疫炎症指数变化及其临床意义探讨

摘要/Abstract

摘要： 目的探究ALP/PLT比值、系统免疫炎症指数在自身免疫性肝炎(AIH)患者中的变化及其临床意义。方法选取2021年10月至2024年9月期间海安市人民医院收治的78例自身免疫性肝炎患者作为研究对象。在治疗6个月后,对生化应答进行评估,完全生化应答患者62例,纳入完全组;应答不完全患者16例,纳入不完全组。所有患者在入院时和治疗后分别进行ALP/PLT比值、系统免疫炎症指数(SII)的检测。数据分析通过SPSS统计软件执行,运用t检验进行比较。应用ROC曲线评估ALP/PLT比值和系统免疫炎症指数对AIH患者应答效能的预测价值。结果完全组患者的丙氨酸氨基转移酶水平为(403.6±44.8)U/L,高于不完全组(359.7±59.5)U/L;总胆红素水平(351.9±52.5)μmol/L,低于不完全组患者(390.7±56.8)μmol/L, P<0.05。完全组治疗前后ALP/PLT比值水平为1.31±0.11、0.73±0.12,低于不完全组(1.51±0.12、1.25±0.14,P<0.05);完全组治疗前后SII为816.54±103.59、645.28±108.56,显著低于不完全组(951.40±114.75、793.66±93.72,P<0.05)。多因素分析结果显示,ALT、汇管区炎症程度、TBil、ALP/PLT、SII均是判断患者生化应答的重要因素(P<0.05)。ROC曲线结果显示,ALP/PLT的AUC为0.906,SII的AUC为0.805,二者联合的AUC为0.952。结论 ALP/PLT比值和系统免疫炎症指数在AIH患者中变化显著,且与疾病活动度密切相关,可以作为预测生化学应答的有效指标,为临床管理提供参考。

关键词: 系统免疫炎症指数, 自身免疫性肝炎, 肝硬化, 生化学应答, 预测效能

Abstract: Objective To investigate the changes in alkaline phosphatase/platelet ratio (ALP/PLT) and the systemic immune inflammation index (SII) in patients with autoimmune hepatitis (AIH) and their clinical significance. Methods This study included 78 patients with AIH who were encountered in Hai'an People's Hospital between October 2021 and September 2024. After 6 months of treatment, biochemical response was assessed. The 62 patients with complete biochemical response were included in the complete group, and 16 patients with incomplete response were included in the incomplete group. ALP/PLT and SII were measured at admission and after treatment. SPSS statistical software was used for data analysis with the t-tests. P<0.05 was considered statistically significant. Applying the receiver operating characteristic (ROC) curves to evaluate the predictive value of the ALP/PLT ratio and systemic immune-inflammation index for treatment response in patients with AIH. Results The alanine aminotransferase (ALT) level in the complete group was (403.6 ± 44.8) U/L, higher than that in the incomplete group (359.7±59.5) U/L; the total bilirubin level was (351.9 ± 52.5) μmol/L, lower than that in the incomplete group (390.7±56.8) μmol/L, P<0.05. In the complete response group, ALP/PLT levels before and after treatment were (1.31 ± 0.11) and (0.73 ± 0.12), which were lower than the incomplete response group (1.51 ± 0.12 and 1.25 ± 0.14), P<0.05. Similarly, SII in the complete response group was (816.54 ± 103.59) before treatment and (645.28 ± 108.56) after treatment, lower than in the incomplete response group (951.40 ± 114.75 before treatment and 793.66 ± 93.72 after treatment), P<0.05. Logistic multivariate regression analysis showed that ALT, the degree of inflammation in the collecting area, TBil, ALP/PLT, and SII were all important factors in determining the biochemical response of the patients (P<0.05). ROC curve analysis showed that the AUC for ALP/PLT was 0.906, the AUC for SII was 0.805, indicating their higher diagnostic value. Conclusion ALP/PLT and the systemic immune inflammation index showed significant changes in AIH patients and were closely related to disease activity. They can be useful indicators for predicting biochemical responses and provide reference for clinical management.

Key words: Systemic immune inflammation index, Autoimmune hepatitis, Cirrhosis, Biochemical response, Predictive efficacy

郑文浩, 日吉使子, 王程煜. 自身免疫性肝炎患者ALP/PLT比值和系统免疫炎症指数变化及其临床意义探讨[J]. 肝脏, 2026, 31(1): 59-63.

ZHENG Wen-hao, RIJI Shi-zi, WANG Cheng-yu. Changes in ALP/PLT and systemic immune inflammation index in patients with autoimmune hepatitis and their clinical significance[J]. Chinese Hepatolgy, 2026, 31(1): 59-63.

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