全身性炎症反应指数对血液透析患者导管相关血流感染的诊断价值。
Diagnostic Value of Systemic Inflammatory Response Index for Catheter-Related Bloodstream Infection in Patients Undergoing Haemodialysis.
机构信息
Department of Infection Management, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.
Department of Nephrology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.
出版信息
J Immunol Res. 2022 Jan 29;2022:7453354. doi: 10.1155/2022/7453354. eCollection 2022.
OBJECTIVE
This study was aimed at investigating the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), and systemic inflammatory response index (SIRI) for catheter-related bloodstream infection (CRBSI) in patients undergoing haemodialysis.
METHODS
A total of 296 patients undergoing haemodialysis with vascular access were selected and divided into the infected (58 patients) and uninfected (238 patients) groups. Their aetiological and general characteristics were retrospectively collected. The NLR, PLR, CAR, and SIRI were calculated.
RESULTS
The NLR, PLR, CAR, and SIRI values in the infected group were significantly higher than those in the uninfected group ( < 0.05). After the anti-infective treatment, the NLR, PLR, CAR, and SIRI values in patients with CRBSI were significantly decreased ( < 0.05). The NLR, CAR, and SIRI showed diagnostic efficacy in patients with CRBSI with cut-off values of 4.485 (area under the curve (AUC) = 0.827, 95%confidence interval (CI) = 0.768-0.887), 0.975 (AUC = 0.836, 95%CI = 0.779-0.892), and 3.390 (AUC = 0.947, 95%CI = 0.919-0.976). The CAR and SIRI values in patients with gram-negative bacterial infection were significantly higher than those with gram-positive bacterial infection ( < 0.05). The AUCs of CAR and SIRI were 0.693 (0.537-0.848) and 0.821 (0.700-0.942) in differentiating gram-negative and gram-positive bacterial infections, respectively.
CONCLUSION
Our results showed SIRI as a novel and efficient indicator for the early diagnosis of CRBSI in patients undergoing haemodialysis.
目的
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、C 反应蛋白与白蛋白比值（CAR）和全身炎症反应指数（SIRI）对血液透析患者导管相关血流感染（CRBSI）的诊断价值。
方法
选择 296 例血管通路行血液透析患者，分为感染组（58 例）和未感染组（238 例）。回顾性收集两组患者的病因和一般特征。计算 NLR、PLR、CAR 和 SIRI。
结果
感染组 NLR、PLR、CAR 和 SIRI 值明显高于未感染组（<0.05）。经抗感染治疗后，CRBSI 患者 NLR、PLR、CAR 和 SIRI 值明显降低（<0.05）。NLR、CAR 和 SIRI 对 CRBSI 患者的诊断效能具有截断值分别为 4.485（曲线下面积（AUC）=0.827，95%置信区间（CI）=0.768-0.887）、0.975（AUC=0.836，95%CI=0.779-0.892）和 3.390（AUC=0.947，95%CI=0.919-0.976）。革兰阴性菌感染患者的 CAR 和 SIRI 值明显高于革兰阳性菌感染患者（<0.05）。CAR 和 SIRI 区分革兰阴性菌和革兰阳性菌感染的 AUC 分别为 0.693（0.537-0.848）和 0.821（0.700-0.942）。
结论
本研究结果表明，SIRI 是血液透析患者 CRBSI 早期诊断的一种新型有效指标。
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