系统免疫炎性反应指数对急性肺栓塞患者病情预后的评估价值  

Predictive value of systematic immune-inflammation index in severity and prognosis of the patients with acute pulmonary embolism

作　　者：杨光[1] Yang Guang(Department of Emergency,Hubei University of Medicine Affiliated Dongfeng General Hospital,Shiyan 442008,China)

机构地区：[1]湖北医药学院附属国药东风总医院急诊科,十堰442008

出　　处：《中国医师进修杂志》2023年第8期702-706,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨系统免疫炎性反应指数(SII)对急性肺栓塞(APE)患者病情预后的评估价值。方法采用回顾性研究的方法,收集2020年6月至2022年1月湖北医药学院附属国药东风总医院收治的120例APE患者的临床资料,以发病6个月内肺栓塞相关死亡作为终点事件。采用多因素Logistic回归分析APE患者肺栓塞相关死亡的影响因素,绘制受试者工作特征(ROC)曲线,分析肺栓塞严重指数(PESI)、SII对患者终点事件的预测价值。结果按照临床终点事件发生情况,120例患者分为存活组(96例)和死亡组(24例)。死亡组年龄、收缩压、心率、呼吸频率、充血性心力衰竭发生率、B型钠尿肽水平、PESI评分、SII高于存活组[(66.00±8.85)岁比(61.21±5.99)岁、(129.83±14.76)mmHg(1 mmHg=0.133 kPa)比(122.77±10.21)mmHg、(102.04±9.43)次/min比(92.54±11.34)次/min、(20.83±2.37)次/min比(19.72±1.77)次/min、41.67%(10/24)比14.58%(14/96)、(211.67±85.38)ng/L比(167.86±71.88)ng/L、(110.17±19.13)分比(89.09±12.63)分、(1068.58±230.65)×10^(9)/L比(784.22±233.98)×10^(9)/L](P<0.05)。多因素Logistic回归分析结果显示,年龄、心率、PESI评分、SII是APE患者肺栓塞相关死亡的独立危险因素(P<0.05)。ROC曲线分析结果显示,PESI预测APE患者肺栓塞相关死亡的曲线下面积为0.816,SII为0.791,两者比较差异无统计学意义(P>0.05)。根据SII的最佳截断值(882.40×10^(9)/L)将其分为SII<882.40×10^(9)/L组(61例)和SII≥882.40×10^(9)/L组(59例),Kaplan-Meier生存分析结果显示SII<882.4×10^(9)/L组6个月生存率高于SII≥882.40×10^(9)/L组,差异有统计学意义(P<0.05)。结论SII能有效评估APE患者预后,可作为评估患者病情的预测指标之一。Objective To investigate the predictive value of systematic immune-inflammation index(SII)in severity and prognosis of the patients with acute pulmonary embolism(APE).Methods By retrospective research methods,the clinical data of 120 APE patients from June 2020 to January 2022 in Hubei University of Medicine Affiliated Dongfeng General Hospital were analyzed.The pulmonary embolism-related deaths within 6 months was the end point events.The influence factors were explored by multivariate Logistic regression analysis,the predictive value of pulmonary embolism severity index(PESI)and SII on the end point events of patients were assessed by receiver operating characteristic(ROC)curve.Results According to the pulmonary embolism-related deaths within 6 months as the end point events they were divided into the survival group(96 cases)and the death group(24 cases).The age,systolic blood pressure,heart rate,respiratory rate,incidence of congestive heart failure,level of B-type natriuretic peptide,PESI score,and SII in the death group were higher than those in the survival group:(66.00±8.85)years vs.(61.21±5.99)years,(129.83±14.76)mmHg(1 mmHg=0.133 kPa)vs.(122.77±10.21)mmHg,(102.04±9.43)beats/min vs.(92.54±11.34)beats/min,(20.83±2.37)beats/min vs.(19.72±1.77)beats/min,41.67%(10/24)vs.14.58%(14/96),(211.67±85.38)ng/L vs.(167.86±71.88)ng/L,(110.17±19.13)scores vs.(89.09±12.63)scores,(1068.58±230.65)×10^(9)/L vs.(784.22±233.98)×10^(9)/L,there were statistical differences(P<0.05).Multivariate Logistic regression analysis showed that age,heart rate,PESI score and SII were the independent risk factors of death related to pulmonary embolism in APE patients(P<0.05).The results of ROC curve showed that the area under curve of PESI and SII for the prediction of pulmonary embolism related death was 0.816 and 0.791,respectively,there was no statistical difference(P>0.05).According to the cut-off of SII(882.40×10^(9)/L),they also assigned to the SII<882.40×10^(9)/L group(61 cases)and the SII≥882.40×10^(9)/L group(5

关 键 词：肺栓塞 系统免疫炎性反应指数 肺栓塞相关死亡 预后 

分 类 号：R563.5[医药卫生—呼吸系统]