全身免疫炎症指数对接受连续性肾脏替代治疗的脓毒症合并急性肾损伤患者短期预测价值  

Predictive value of systemic immune-inflammation index(SII)for short-term prognosis in patients with sepsis complicated with acute kidney injury receiving CRRT

作　　者：尹帅 陈欣[1] 徐雁[1] 高天巍[1] Yin Shuai;Chen Xin;Xu Yan;Gao Tianwei(Department of Critical Care Medicine,Hangzhou Cancer Hospital,Hangzhou 310002,China)

机构地区：[1]杭州市肿瘤医院重症医学科,杭州310002

出　　处：《中华内分泌外科杂志》2022年第3期356-360,共5页Chinese Journal of Endocrine Surgery

基　　金：杭州市医药卫生科技项目(A20220169)。

摘　　要：目的评估全身免疫炎症指数(systemic immune inflammation index,SII)对接受连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)的脓毒症合并急性肾损伤患者短期预后的预测价值。方法纳入2018年2月至2022年1月杭州市肿瘤医院收治的90例接受CRRT的脓毒症合并急性肾损伤患者为研究对象,根据90 d内患者生存情况将其分为生存组60例和死亡组30例,记录其年龄、序贯器官功能衰竭评估(SOFA)评分、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)、白蛋白(ALB)等临床基线资料。采用全自动血细胞分析仪检测接受CRRT的脓毒症合并急性肾损伤患者外周静脉血中淋巴细胞计数、血小板计数、中性粒细胞计数,计算SII;采用Pearson相关分析接受CRRT的脓毒症合并急性肾损伤死亡患者SII与临床基线资料的相关性;绘制ROC曲线分析比较SII、SOFA评分、APACHEII对接受CRRT的脓毒症合并急性肾损伤患者死亡的预测价值;采用Kaplan-Meier曲线描述患者生存变化情况;采用多因素Cox回归分析影响接受CRRT的脓毒症合并急性肾损伤患者90 d死亡的因素。结果死亡组SII(2636.74)、C反应蛋白(CRP)[(92.45±29.74)mg/L]、SOFA评分(12.83±3.24)、APACHEII(28.30±7.51)高于生存组[(341.92)、(50.24±16.13)mg/L、(10.00±3.12)、(25.13±6.87)],ALB[(2.50±0.53)g/dl]低于生存组[(2.79±0.61)g/dl](P<0.05)。接受CRRT的脓毒症合并急性肾损伤死亡患者SII与CRP、SOFA评分、APACHEII呈显著正相关,与ALB呈显著负相关(P<0.05)。SII、SOFA评分、APACHEII预测接受CRRT的脓毒症合并急性肾损伤患者死亡的曲线下面积(AUC)分别为0.936、0.827、0.736,其中SII预测AUC大于SOFA评分、APACHEII(P<0.05)。高SII组(23/46,50.00%)接受CRRT的脓毒症合并急性肾损伤患者90 d生存率低于低SII组(37/44,84.09%)(P<0.05)。SII是接受CRRT的脓毒症合并急性肾损伤患者90 d内死亡的独立危险因素(P<0.05)。结论SII能较好地预测接�Objective To evaluate the predictive value of systemic immune inflammation index(SII)for short-term prognosis in patients with sepsis complicated with acute kidney injury who received continuous renal replacement therapy(CRRT).Methods From Feb.2018 to Jan.2022,90 patients with sepsis complicated with acute kidney injury who received CRRT in Hangzhou Cancer Hospital were included as the research objects.According to the survival of patients within 90 days,they were grouped into a survival group of 60 cases and a death group of 30 cases.The clinical baseline data such as age,sequential organ failure assessment(SOFA)score,acute physiological function and chronic health status scoring system II(APACHE II),albumin(ALB)were recorded.Automatic blood cell analyzer was applied to detect lymphocyte count,platelet count and neutrophil count in peripheral venous blood of patients with sepsis complicated with acute kidney injury who received CRRT,and the SII was calculated;Pearson correlation analysis was performed to analyze the correlation between SII and clinical baseline data in dead patients with sepsis complicated with acute kidney injury receiving CRRT;ROC curve was drawn to analyze and compare the predictive value of SII,SOFA score and APACHEII for death in patients with sepsis complicated with acute kidney injury receiving CRRT;Kaplan-Meier curve was performed to describe the changes in patient survival;multivariate Cox regression analysis was performed to analyze the factors affecting 90-day death in patients with sepsis complicated with acute kidney injury receiving CRRT.Results SII(2636.74),C-reactive protein(CRP)[(92.45±29.74)mg/L],SOFA score(12.83±3.24)and APACHEII(28.30±7.51)in the death group were higher than those in the survival group[341.92,(50.24±16.13)mg/L,10.00±3.12,25.13±6.87],and ALB[(2.50±0.53)g/dl]was lower than that in the survival group[(2.79±0.61)g/dl](P<0.05).SII was significantly positively correlated with CRP,SOFA score and APACHEII,and significantly negatively correlated with ALB in pa

关 键 词：脓毒症 急性肾损伤 连续性肾脏替代治疗 全身免疫炎症指数 

分 类 号：R692[医药卫生—泌尿科学]