全身免疫炎症指数对非ST段抬高型心肌梗死患者早期发生急性心力衰竭的预测价值  

Predictive value of systemic immune inflammation index for early onset of acute heart failure in patients with non-ST-elevation myocardial infarction

作　　者：张忠满 朱轶 陈旭锋 王连生[2] 武澎 ZHANG Zhongman;ZHU Yi;CHEN Xufeng;WANG Liansheng;WU Peng(Department of Emergency and Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院急诊与危重症医学科,江苏南京210029 [2]南京医科大学第一附属医院心血管内科,江苏南京210029

出　　处：《南京医科大学学报(自然科学版)》2025年第3期382-388,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(82000335)。

摘　　要：目的:探讨全身免疫炎症指数(systemic immune inflammation index,SII)对非ST段抬高型心肌梗死(non-ST-elevation myocardial infarction,NSTEMI)患者早期发生急性心力衰竭(acute heart failure,AHF)的预测价值。方法:采用回顾性研究,收集2023年9月—2024年9月于南京医科大学第一附属医院心血管内科住院的NSTEMI患者临床资料,通过Spearman相关性分析探讨入院SII与入院1周内N末端B型利钠肽原(N-terminal pro-brain natriuretic peptide,NT-proBNP)峰值之间的相关性。使用受试者工作特征(receiver operating characteristic,ROC)曲线和基于Logistic回归的限制性立方样条(restricted cubic spline,RCS)分析探讨SII与NSTEMI患者早期AHF发生风险间的具体关系。结果:共纳入202例NSTEMI患者,其中104例(51.5%)患者在入院1周内发生AHF。AHF组患者SII水平明显高于无AHF组患者[1 390.55(939.45,2 459.93)vs.667.15(431.58,1 140.25),P <0.001]。ROC曲线下面积达0.745(95%CI:0.677~0.812,P <0.001)。Spearman相关分析结果显示入院SII与入院1周内NT-proBNP峰值之间存在线性相关,相关系数为0.317(P <0.001)。RCS曲线显示,NSTEMI患者早期发生AHF的风险与SII呈线性正相关。结论:SII对NSTEMI患者早期发生AHF具有预测价值,NSTEMI患者早期发生AHF的风险随SII增加而增加。Objective:To explore the predictive value of the systemic immune inflammation index(SII)for early acute heart failure(AHF)in non-ST-elevation myocardial infarction(NSTEMI)patients.Methods:A retrospective study was carried out to collect the clinical data of NSTEMI patients admitted to the department of Cardiology at the First Affiliated Hospital of Nanjing Medical University from September 2023 to September 2024.Spearman correlation analysis was employed to investigate the correlation between the admission SII and the peak value of N-terminal pro-brain natriuretic peptide(NT-proBNP)within one week after admission.Based on the receiver operating characteristic(ROC)curve and the restricted cubic spline(RCS)based on logistic regression analysis,the specific relationship between SII and the risk of AHF in NSTEMI patients was explored.Results:A total of 202 NSTEMI patients were included,among whom 104(51.5%)developed AHF within one week of admission.The level of SII in patients with AHF was significantly higher than that in patients without AHF[1 390.55(939.45,2 459.93)vs.667.15(431.58,1 140.25),P < 0.001].The area under the ROC curve was 0.745(95%CI:0.677-0.812,P < 0.001).Spearman correlation analysis indicated that there was a linear correlation between the admission SII and the peak value of NT-proBNP within one week of admission,and the correlation coefficient was 0.317(P < 0.001).The RCS curve demonstrated a linear positive correlation between the risk of early AHF in NSTEMI patients and SII.Conclusion:The SII exhibits predictive value for the early onset of AHF in NSTEMI patients,with the risk of early AHF increasing as SII levels rise.

关 键 词：全身免疫炎症指数 非ST段抬高型心肌梗死 急性心力衰竭 限制性立方样条 

分 类 号：R542.22[医药卫生—心血管疾病]