流行性感冒致肝损害的危险因素分析及其与血清NLR、SII水平的相关性OA

Objective To investigate the risk factors for influenza-associated liver injury and its correlation with novel serum inflammatory markers,the neutrophil lymphocyte count ratio(NLR)and systemic immune inflammation index(SII).Methods Clinical data from adult influenza inpatients admitted to the Department of Infectious Diseases,Nanjing Drum Tower Hospital Group Suqian Hospital between January 1,2018,and March 31,2022,were retrospectively collected via the hospital electronic medical record system.Patients were stratified into liver dysfunction group and normal liver function group.Statistical analyses compared clinical characteristics between groups.Variables with significant differences in univariate analysis were incorporated into multivariate Logistic regression to identify risk factors.Correlation analysis assessed relationships between NLR,SII and liver injury.Results A total of 251 patients were included in the present study,of whom 192 were assigned to normal liver function group and 59 to abnormal liver function group,yielding an incidence rate of influenza-associated liver injury of 23.5%.In terms of liver biochemical abnormalities,elevated total bilirubin was observed in 2 cases,elevated alanine aminotransferase in 37 cases,elevated aspartate aminotransferase in 23 cases,elevated gammaglutamy transpeptidase in 41 cases,and elevated alkaline phosphatase in 6 cases.Univariate analysis demonstrated that male,age,neutrophil count,neutrophil percentage,lactate dehydrogenase,creatinine,NLR,and SII were significantly higher in patients with abnormal liver function than in those with normal liver function,with all differences reaching statistical significance(P<0.05).Multivariate Logistic regression analysis further identified that male(OR=5.238,95%CI:2.460-11.153,P<0.001)and elevated lactate dehydrogenase level(OR=1.014,95%CI:1.008-1.019,P<0.001)were independent risk factors for influenza-related liver dysfunction.Receiver operating characteristic curve analysis showed that the area under the curve of lactate dehydrogenase for predicting influenza-associated liver injury was 0.724.Additionally,both NLR and SII were positively correlated with liver injury in influenza patients(r=0.170,r=0.129,P<0.05).Conclusion Male and elevated lactate dehydrogenase are risk factors for influenza-associated liver injury.NLR and SII demonstrate positive correlations with liver damage,suggesting their potential as predictive biomarkers for influenza-related hepatic complications.