全身免疫炎症指数与中老年2型糖尿病患者颈动脉不稳定斑块的相关性及其预测价值  

Correlation and Predictive Value of Systemic Immune-Inflammation Index for Carotid Unstable Plaque in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus

作　　者：郭慧娟 李天艺[1] 李媛媛[1] GUO Huijuan;LI Tianyi;LI Yuanyuan(Department of Geriatric Endocrinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院老年内分泌科,河南郑州450000

出　　处：《河南医学研究》2023年第2期222-226,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202102161)。

摘　　要：目的探讨全身免疫炎症指数(SII)与中老年2型糖尿病(T2DM)患者颈动脉不稳定斑块的相关性及其预测价值。方法收集郑州大学第一附属医院老年内分泌科及内分泌科2021年3月至2022年3月收治的431例中老年T2DM患者为研究对象。收集患者的临床资料及实验室指标,根据双侧颈动脉超声结果分为:无斑块组(n=158),稳定斑块组(n=115),不稳定斑块组(n=158)。分析3组间临床资料及实验室指标的差异,采用多因素logistic回归分析影响颈动脉不稳定斑块的危险因素,通过受试者工作特征(ROC)曲线评估SII、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)对颈动脉不稳定斑块的预测价值。结果不稳定斑块组的男性比率、吸烟比率、饮酒比率、糖尿病病程、低密度脂蛋白胆固醇(LDL-C)、NLR、PLR、SII均高于稳定斑块组(P<0.05);多因素logistic回归结果示,NLR、PLR、SII是影响颈动脉不稳定斑块的独立危险因素(P<0.05);ROC曲线显示,SII、NLR、PLR预测颈动脉不稳定斑块的曲线下面积(AUC)分别为0.744、0.711、0.648,灵敏度分别为62.7%、60.1%、83.5%,特异度分别为80.0%、73.0%、40.9%,截断值分别为455.01、2.06、102.30。结论SII为中老年T2DM患者颈动脉不稳定斑块的独立危险因素,对颈动脉不稳定斑块的诊断具有预测价值,且SII的预测价值优于NLR、PLR,可为缺血性脑卒中的预防提供参考。Objective To investigate the correlation between systemic immune-inflammation index(SII)and carotid unstable plaque and its predictive value in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 431 middle-aged and elderly patients with T2DM admitted to the Department of Geriatric Endocrinology and Endocrinology of the First Affiliated Hospital of Zhengzhou University from March 2021 to March 2022 were selected as the study objects.Clinical data and laboratory indicators of patients were collected.According to bilateral carotid artery ultrasound results,patients were divided into no plaque group(n=158),stable plaque group(n=115)and unstable plaque group(n=158).The differences of clinical data and laboratory indicators among the three groups were analyzed.Multivariate logistic regression was used to analyze the risk factors of carotid unstable plaque.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of SII,neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)for carotid plaque instability.Results The proportion of male,smoking,drinking,duration of diabetes,low density lipoprotein cholesterol(LDL-C),NLR,PLR and SII in unstable plaque group were higher than those in stable plaque group(P<0.05).Multivariate logistic regression showed that NLR,PLR and SII were independent risk factors for carotid unstable plaque(P<0.05).The results of ROC curve showed that the area under the curve(AUC)of SII,NLR and PLR in predicting carotid unstable plaque were 0.744,0.711 and 0.648,the sensitivities were 62.7%,60.1%and 83.5%,the specificities were 80.0%,73.0%and 40.9%,and the cut-off values were 455.01,2.06 and 102.30,respectively.Conclusion SII is an independent risk factor for carotid unstable plaque in middle-aged and elderly patients with T2DM,which has predictive value for the diagnosis of carotid unstable plaque.The predictive value of SII was better than that of NLR and PLR,which can provide a reference for the prevention of cerebral i

关 键 词：2型糖尿病 缺血性脑卒中 全身免疫炎症指数 颈动脉不稳定斑块 中老年 

分 类 号：R543.4[医药卫生—心血管疾病]