The Value Of SII And PNI In Evaluating The Severity Of Community-acquired Pneumonia In Children

Objective:To explore the evaluation value of systemic immune inflammation index(SII)and prognostic nutritional index(PNI)on the severity of community-acquired pneumonia in children,so as to provide reference for clinicians to judge the severity of community-acquired pneumonia in children.Method:274 children with community-acquired pneumonia hospitalized in pediatrics of the Affiliated Hospital of North Sichuan Medical College from November 2019 to October 2021 were analyzed retrospectively.According to the severity of the disease,they were divided into severe pneumonia group(164 cases)and mild pneumonia group(110 cases).The general data and laboratory examination data of the children were recorded.In addition,76 healthy children in the same period were selected as the control group.SII,PNI,neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)were calculated according to the peripheral blood neutrophil count,lymphocyte count,platelet count and albumin value at admission.The differences of laboratory indexes among the three groups were compared.Spearman correlation analysis was used to evaluate the correlation between SII,PNI,C-reactive protein(CRP)and procalcitonin(PCT).The receiver operating characteristic curve(ROC)was drawn tol evaluate the diagnostic efficacy of SII,PNI,CRP,PCT,PLR and NLR in the severity of children with community-acquired pneumonia.Results:(1)The level of SII in severe group was higher than that in mild group and control group,and that in mild group was higher than that in control group,the difference was statistically significant(P<0.05);The PNI level of severe group was lower than that of mild group and control group,and that of mild group was lower than that of control group,the difference was statistically significant(P<0.05);The PLR level of severe group was higher than that of mild group and control group,and that of mild group was higher than that of control group,the difference was statistically significant(P<0.05);The NLR level of severe group was higher than that of mild group and control group,and that of mild group was higher than that of control group,the difference was statistically significant(P<0.05).(2)Spearman correlation analysis showed that SII was positively correlated with PCT(r=0.25,P<0.001),SII was positively correlated with CRP(r=0.50,P<0.001),PNI was negatively correlated with PCT(r=-0.27,P<0.001),PNI was negatively correlated with CRP(r=-0.40,P<0.001),PNI was negatively correlated with SII(r=-0.46,P<0.001).(3)The ROC curve showed that the area under the curve(AUC)of SII and PNI were 0.73 and 0.67,respectively.The best cut-off values were 209.82 and 50.2,respectively.The sensitivity was 0.86 and 0.85,and the specificity was 0.48 and 0.47.The areas under the NLR and PLR curves were 0.70 and 0.68 respectively,the best cut-off values were 1.57 and 123.72 respectively,the sensitivity was 0.56 and 0.53 respectively,and the specificity was 0.73 and 0.79 respectively.The areas under the curves of CRP and PCT were 0.65 and 0.67 respectively,the best cut-off values were 13.65 mg/L and 1.68 ng/mL respectively,the sensitivity was 0.49 and 0.36 respectively,and the specificity was 0.80 and 0.94 respectively.Conclusion:The SII value of children with community-acquired pneumonia at admission may have a certain value in assessing the severity of the disease,but the value of PNI value in assessing the severity of children with community-acquired pneumonia is limited.