系统免疫炎症指数对肺癌患者合并静脉血栓栓塞症的预测价值  

Predictive value of systemic immune-inflammatory index for complicating venous thrombo embolism in patients with lung cancer

作　　者：凤婧[1] 罗凤鸣[2] 杨颖 韩娟[1] 胡晓波 FENG Jing;LUO Fengming;YANG Ying;HAN Juan;HU Xiaobo(Department of Respiratory and Critical Care Medicine,Chengdu Municipal Second People’s Hospital,Chengdu,Sichuan 610017,China;Department of Respiratory and Critical Care Medicine,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China;Department of Medical Administration,Chengdu Municipal Second People’s Hospital,Chengdu,Sichuan 610017,China)

机构地区：[1]成都市第二人民医院呼吸与危重症医学科,成都610017 [2]四川大学华西医院呼吸与危重症医学科,成都610041 [3]成都市第二人民医院医务科,成都610017

出　　处：《重庆医学》2024年第15期2308-2312,2318,共6页Chongqing Medical Journal

基　　金：四川省医学会科研基金专项科研课题(2021HR12)。

摘　　要：目的探讨系统免疫炎症指数(SII)对肺癌患者合并静脉血栓栓塞症(VTE)的预测价值。方法选取2022年3月至2023年10月在成都市第二人民医院就诊的肺癌患者为研究对象,根据是否合并VTE分为VTE组(n=33)和非VTE组(n=37)。收集并分析患者临床特征及实验室指标,多因素logistic回归分析影响因素,绘制受试者工作特征(ROC)曲线,比较ROC曲线下面积(AUC)有无差异,Kaplan-Meier生存曲线评估相关变量对肺癌患者发生VTE风险的分层能力。结果两组WBC、中性粒细胞、淋巴细胞、白蛋白(ALB)、D-二聚体(D-D)、血浆黏度、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及系统免疫炎症指数(SII)比较差异有统计学意义(P<0.05)。多因素logistic回归分析显示,高SII、肿瘤分期(Ⅲ~Ⅳ期)、血浆黏度是肺癌患者发生VTE的独立危险因素(P<0.05)。ROC曲线分析显示,Khorana评分、SII、改良Khorana评分、NLR、PLR的AUC分别为0.747、0.776、0.866、0.754、0.672。SII对肺癌患者发生VTE的预测效能优于Khorana评分、NLR及PLR。结论高SII是肺癌患者发生VTE的独立危险因素,其预测效能优于NLR、PLR、Khorana评分,且可用于优化Khorana风险评估模型,用其对肺癌患者发生VTE风险的分层有助于早期识别高危人群。Objective To investigate the predictive value of systemic immune-inflammation index(SII)for venous thrombo embolism(VTE)in patients with lung cancer.Methods The patients with lung cancer admitted and treated in Chengdu Municipal Second People’s Hospital from March 2022 to October 2023 were selected as the study subjects and divided into the VTE group(n=33)and the non-VTE group(n=37)according to whether or not complicating VTE.The clinical characteristics and laboratory indexes were collected.The multivariate logistic regress was used to analyze the influencing factors.The receiver operating characteristic(ROC)curve was drawn.The difference of the areas under curve(AUC)was compared.The Kaplan-Meier survival curve was used to evaluate the risk stratification capability of the related variables for VTE occurrence in the patients with lung cancer.Results There were statistically significant differences in WBC,neutrophil,lymphocyte,albumin(ALB),D-dimer(D-D),plasma viscosity,neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and SII between the two groups(P<0.05).The multivariate logistic regression analysis showed that high SII,tumor stage(Ⅲ-Ⅳstage)and plasma viscosity were inde-pendent risk factors for VTE occurrence in the patients with lung cancer(P<0.05).The ROC curve analysis showed that AUC of the Khorana score,SII,modified Khorana score,NLR and PLR were 0.747,0.776,0.866,0.754 and 0.672,respectively.The predictive efficiency of SII for VTE occurrence in the patients with lung cancer was better than that of Khorana score,NLR and PLR.Conclusion High SII is an independent risk factor for VTE occurrence in the patients with lung cancer,its risk stratification for VTE occurrence in the patients with lung cancer is conducive to early recognize the high risk population.

关 键 词：系统免疫炎症指数 肺癌 静脉血栓栓塞症 

分 类 号：R563.9[医药卫生—呼吸系统]