系统性免疫炎症指数对稳定型冠心病患者远期主要不良心血管事件的预测价值  

Predictive value of systemic immune inflammation index to long-term major adverse cardiovascular events in patients with stable coronary heart disease

作　　者：苏琳 张阿喜 姚杰 张博 Su Lin;Zhang Axi;Yao Jie;Zhang Bo(Department of Cardiovascular Medicine,Central Hospital of Xianyang City,Xianyang 712000,China;不详)

机构地区：[1]咸阳市中心医院心血管内科,咸阳712000

出　　处：《中国循证心血管医学杂志》2024年第12期1527-1530,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨系统性免疫炎症指数对稳定型冠状动脉粥样硬化性心脏病(冠心病)患者远期主要不良心血管事件(Major Adverse Cardiovascular Events,MACE)的预测价值。方法选择2017年1月至2018年12月于咸阳市中心医院收治的稳定型冠心病患者473例,随访5年,根据是否发生MACE,将患者分为MACE组(n=113)和对照组(n=360),比较两组临床特征和系统性免疫炎症指数差异,分析系统性免疫炎症指数对MACE的预测价值以及远期MACE的危险因素。结果与对照组患者比较,MACE组年龄增加(67.51±11.76岁vs.61.48±12.05岁,P<0.001);左室射血分数降低(49.70±6.18%vs.52.60±6.42%,P<0.001);冠状动脉多支病变比例增加(65.49%vs.40.28%,P<0.001);平均冠状动脉狭窄程度增加(81.20±10.19%vs.72.19±10.61%,P<0.001);系统性免疫炎症指数增加(902.37±312.58 vs.645.87±221.04,P<0.001);药物依从率差的患者比例增加(39.82%vs.22.22%,P<0.001)。系统性免疫炎症指数对稳定型冠心病患者远期MACE具有较好的价值,曲线下面积(AUC)为0.731(95%CI:0.678~0.792)。系统性免疫炎症指数与稳定型冠心病患者左室射血分数显著负相关(r=-0.241,P=0.002),与冠状动脉狭窄程度呈正相关(r=0.304,P<0.001)。系统性性免疫炎症指数≥692为稳定型冠心病患者发生MACE的危险因素(P=0.001),相对危险度(RR)为2.238(95%CI:1.032~4.585)。结论系统性免疫炎症指数可作为稳定型冠心病患者发生MACE的预测指标,对于系统性免疫炎症指数升高的患者应加强监测,减少MACE的发生。Objective To discuss the predictive value of systemic immune inflammation index(SII)to long-term major adverse cardiovascular events(MACE)in patients with stable coronary heart disease(CHD).Methods The patients with stable CHD(n=473)were chosen,and according to MACE occurrence status,divided into MACE group(n=113)and control group(n=360)in Central Hospital of Xianyang City from Jan.2017 to Dec.2018.The differences in clinical features and SII were compared between 2 groups.The predictive value of SII to MACE and risk factors for long-term MACE were analyzed.Results The levels of age increased(67.51±11.76 vs.61.48±12.05,P<0.001)and left ventricular ejection fraction(LVEF,49.70±6.18%vs.52.60±6.42%,P<0.001)decreased,percentage of coronary multi-vessel lesions increased(65.49%vs.40.28%,P<0.001),mean severity of coronary artery stenosis increased(81.20±10.19%vs.72.19±10.61%,P<0.001),SII increased(902.37±312.58 vs.645.87±221.04,P<0.001),and percentage of patients with poor medication compliance increased(39.82%vs.22.22%,P<0.001)in MACE group compared with control group.SII had a higher value to long-term MACE with AUC=0.731(95%CI:0.678~0.792)in patients with stable CHD.SII was significantly correlated to LVEF(r=-0.241,P=0.002),and positively correlated to severity of coronary artery stenosis(r=0.304,P<0.001).When SII≥692,it was a risk factor for MACE occurrence(P=0.001,RR=2.238,95%CI:1.032~4.585).Conclusion SII can be taken as a predictive index for MACE occurrence in patients with stable CHD.For patients with increased SII,monitoring should be strengthened to reduce MACE occurrence.

关 键 词：系统性免疫炎症指数 稳定型冠心病 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]