系统免疫炎症指数与2型糖尿病合并冠心病及冠状动脉病变严重程度的关系  

Relationship between Systemic Immune Inflammation Index and Type 2 Diabetes Mellitus Combined with Coronary Heart Disease and Severity of Coronary Artery Disease

作　　者：王可 王梦珍 万枕驰 吴齐 应长江 凌宏威 WANG Ke;WANG Mengzhen;WAN Zhenchi;WU Qi;YING Changjiang;LING Hongwei(Graduate School of Xuzhou Medical University,Xuzhou 221000,China;Department of Endocrinology,Xuzhou Medical University Affiliated Hospital,Xuzhou 221000,China)

机构地区：[1]徐州医科大学研究生院,江苏省徐州市221000 [2]徐州医科大学附属医院内分泌科,江苏省徐州市221000

出　　处：《实用心脑肺血管病杂志》2024年第9期32-37,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省中医药科技发展计划项目(MS2022141)。

摘　　要：目的探讨系统免疫炎症指数(SII)与2型糖尿病(T2DM)合并冠心病及冠状动脉病变严重程度的关系。方法回顾性选取2021年9月—2023年9月徐州医科大学附属医院收治的T2DM患者410例为研究对象,收集患者的临床资料,根据冠状动脉造影结果将患者分为T2DM组130例和T2DM合并冠心病组280例。根据Gensini评分中位数将T2DM合并冠心病组患者分为低Gensini评分亚组(Gensini评分<41分,n=139)和高Gensini评分亚组(Gensini评分≥41分,n=141)。采用多因素Logistic回归分析探讨T2DM合并冠心病的影响因素;采用ROC曲线分析SII预测T2DM合并冠心病的价值;采用Pearson相关分析探讨T2DM合并冠心病患者SII与Gensini评分的相关性。结果T2DM合并冠心病组男性占比、有高血压史者占比、中性粒细胞计数(NE)、血小板计数(PLT)、肌酐、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、SII高于T2DM组,糖尿病病程长于T2DM组(P<0.05)。多因素Logistic回归分析结果显示,糖尿病病程、高血压史、肌酐、FPG、SII是T2DM合并冠心病的独立影响因素(P<0.05)。ROC曲线分析结果显示,SII预测T2DM合并冠心病的AUC为0.779[95%CI(0.726~0.832)],最佳截断值为421×10^(9)/L,灵敏度为87.1%,特异度为61.5%。高Gensini评分亚组有吸烟史者占比、白细胞计数(WBC)、NE、PLT、肌酐、HbA1c、TG、NLR、PLR、SII高于低Gensini评分亚组(P<0.05)。Pearson相关分析结果显示,T2DM合并冠心病患者SII与Gensini评分呈正相关(r=0.435,P<0.001)。结论SII是T2DM合并冠心病的独立影响因素,其对T2DM合并冠心病具有一定预测价值,且T2DM合并冠心病患者SII与Gensini评分呈正相关,SII可在一定程度上反映T2DM合并冠心病患者冠状动脉病变严重程度。Objective To explore the relationship between systemic immune inflammation index(SII)and type 2 diabetes mellitus(T2DM)combined with coronary heart disease and severity of coronary artery disease.Methods A total of 410 T2DM patients admitted to Xuzhou Medical University Affiliated Hospital from September 2021 to September 2023 were selected as the research subjects.The clinical data of the patients were collected,the patients were divided into T2DM group(n=130)and T2DM combined with coronary heart disease group(n=280)according to the coronary angiography results.In the T2DM combined with coronary heart disease group,the patients were divided into low Gensini score subgroup(Gensini score<41,n=139)and high Gensini score subgroup(Gensini score≥41,n=141)based on the median Gensini score.Multivariate Logistic regression analysis was used to explore the influencing factors of T2DM combined with coronary heart disease.The ROC curve was used to explore the predictive value of SII for T2DM combined with coronary heart disease.Pearson correlation analysis was used to explore the correlation between SII and Gensini score in patients with T2DM combined with coronary heart disease.Results The proportion of males,proportion of patients with hypertension history,neutrophil count(NE),platelet count(PLT),creatinine,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),neutrophils to lymphocytes ratio(NLR),platelets to lymphocytes ratio(PLR),and SII in T2DM combined with coronary heart disease group were higher than those in T2DM group,and diabetes duration was longer than that in T2DM group(P<0.05).Multivariate Logistic regression analysis showed that diabetes duration,hypertension history,creatinine,FPG,SII were the independent influencing factors for T2DM combined with coronary heart disease(P<0.05).ROC curve analysis showed that the AUC of the SII in predicting T2DM combined with coronary heart disease was 0.779[95%CI(0.726-0.832)],the best cutoff value was 421×10^(9)/L,the sensitivity was 87.1%,the specificity was 61.

关 键 词：糖尿病 2型 冠心病 系统免疫炎症指数 GENSINI评分 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]