外周血衍生炎症标志物SII和SIRI对急性心肌梗死患者院内不良心血管事件的预测价值  

The predictive value of peripheral blood-derived inflammatory markers SII and SIRI for in-hospital adverse cardiovascular events in patients with acute myocardial infarction

作　　者：唐锴 刘磊 谭震 黄刚[1] 邓学军[1] 周世恒[1] TANG Kai;LIU Lei;TAN Zhen;ZHUANG Gang;DENG Xuejun;ZHOU Shiheng(Cardiovascular Center of Suining Central Hospital,Suning,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院心血管中心,四川省遂宁市629000

出　　处：《中国动脉硬化杂志》2024年第7期606-612,共7页Chinese Journal of Arteriosclerosis

基　　金：四川省基层卫生事业发展研究中心2020年立项项目(SWFZ20-Q-058)。

摘　　要：[目的]探讨全身炎症免疫指数(SII)和全身炎症反应指数(SIRI)与急性心肌梗死(AMI)患者院内发生主要不良心血管事件(MACE)风险的预测价值。[方法]回顾性分析2021年2月─2022年5月于遂宁市中心医院心血管二病区住院治疗的AMI患者,结合纳入、排除标准,最终入选246例患者。根据住院期间是否发生MACE分为事件组与非事件组,进行两组基线资料比较。将除外SII和SIRI的所有变量纳入单因素-多因素Logistic回归分析筛选影响MACE风险的因素,并将其作为显著性协变量进行校正,从而分别评估SII和SIRI与MACE风险的关系。[结果]多因素Logistic回归分析结果显示,急诊PCI、左心室射血分数、白蛋白水平及年龄是影响AMI患者院内发生MACE风险的独立影响因素(OR=0.432,95%CI:0.194~0.960,P=0.038;OR=0.930,95%CI:0.890~0.969,P=0.001;OR=0.730,95%CI:0.621~0.845,P<0.001;OR=1.143,95%CI:1.070~1.228,P<0.001),并以此建立基础模型;通过多因素Logistic回归分析分别将SII与SIRI校正上述显著性协变量后,两者都是AMI患者院内发生MACE风险的独立危险因素(OR=1.004,95%CI:1.001~1.008,P=0.002;OR=4.467,95%CI:2.597~8.142,P<0.001)。SII和SIRI的曲线下面积分别为0.658和0.785,最佳临界值分别为434.83和1.03。限制性立方样条分析显示,在校正显著性协变量后,SII(Nonlinear P=0.639)与SIRI(Nonlinear P=0.683)与MACE风险呈线性关系。阈值效应分析显示,当SIRI>0.93时,MACE风险开始增加。[结论]SII和SIRI水平升高是AMI患者院内发生MACE风险的独立危险预测因素。Aim To investigate the relationship between systemic inflammatory immune index(SII)and systemic inflammatory response index(SIRI)and the risk of in-hospital major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI).Methods Retrospective analysis was conducted on AMI patients admitted to the Second Cardiovascular Disease Area of Suining Central Hospital from February 2021 to May 2022.Based on inclusion and exclusion criteria,246 patients were finally enrolled.According to whether MACE occurred during hospitalization,they were divided into event group and non-event group,and baseline data of the two groups were compared.All variables except SII and SIRI were included in a univariate-multivariate Logistic regression analysis to screen factors affecting the risk of MACE,and were used as significant covariates for adjustment to evaluate the relationship between SII and SIRI and the risk of MACE respectively.Results The results of multivariate Logistic regression analysis showed that emergency PCI,left ventricular ejection fraction,albumin level and age were significant factors affecting the risk of in-hos-pital MACE in AMI patients(OR=0.432,95%CI:0.194~0.960,P=0.038;OR=0.930,95%CI:0.890~0.969,P=0.001;OR=0.730,95%CI:0.621~0.845,P<0.001;OR=1.143,95%CI:1.070~1.228,P<0.001),and a basic model was established based on this.After adjusting for the significant covariates,SII and SIRI were both independent risk factors for in-hospital MACE(OR=1.004,95%CI:1.001~1.008,P=0.002;OR=4.467,95%CI:2.597~8.142,P<0.001).The areas under the curves of SII and SIRI were 0.658 and 0.785,respectively,and the optimal cutoff values were 434.83 and 1.03.Restricted cubic spline analysis showed that SII(Nonlinear P=0.639)and SIRI(Nonlinear P=0.683)were linearly related to the risk of MACE after adjusting significant covariates.Threshold effect analysis showed that when SIRI>0.93,the risk of MACE began to increase.Conclusion Elevated levels of SII and SIRI are independent risk predictors for the occurrence of in-hos

关 键 词：急性心肌梗死 全身炎症免疫指数 全身炎症反应指数 主要不良心血管事件 

分 类 号：R5[医药卫生—内科学]