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全身免疫炎症指数对接受血管内治疗的急性缺血性脑卒中患者脑再灌注及临床结局的预测价值

Predictive value of systemic immune-inflammation index for cerebral reperfusion and clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment.

作者信息

Acar B A, Acar T, Vatan M B, Aras Y G, Ulaş S B, Eryılmaz H A, Dalkılıç Ş, Zafer A P, Turhan O, Vatan A, Varım P, Kaya T

机构信息

Department of Neurology, Department of Cardiology, Department of Infectious Disease, Department of Internal Medicine, Sakarya University Training and Research Hospital, Sakarya, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2022 Aug;26(16):5718-5728. doi: 10.26355/eurrev_202208_29507.

Abstract

OBJECTIVE

The systemic immune inflammation (SII) index has been an excellent prognostic indicator in patients with acute ischemic stroke (AIS). In this study, we assessed the utility of the SII in predicting the prognosis and reperfusion status of patients with AIS who underwent endovascular treatment (EVT).

PATIENTS AND METHODS

123 consecutive AIS patients were enrolled in our study. The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of SII for predicting unsuccessful cerebral reperfusion. Multivariate logistic regression analysis analyzed the association between SII and unsuccessful reperfusion rate after EVT.

RESULTS

The median value of SII was significantly higher in patients with unsuccessful reperfusion compared to patients with successful reperfusion [2,029 (1,217-2,771) vs. 1,172 (680-2,145) respectively, p=0.003)]. A ROC curve analysis showed that the best cut-off value of SII for predicting unsuccessful reperfusion status was 1,690, with sensitivity and specificity of 71% and 69%, respectively. The area under the curve (AUC) was 0.673 (95% CI; 0.552-0.793). Multivariate analysis demonstrated that SII ≥ 1,690 value was an independent predictor of unsuccessful cerebral reperfusion and unfavorable clinical outcome after EVT (Hazard ratio - H.R.=3.713, 95% CI: 1.281-10.76, p=0.016, HR=2.28, 95% CI: 1.06-4.88, p=0.035, respectively).

CONCLUSIONS

We suggested that SII is a potential indicator to predict the unsuccessful cerebral reperfusion and unfavorable clinical outcome for patients with AIS undergoing EVT.

摘要

目的

全身免疫炎症(SII)指数一直是急性缺血性卒中(AIS)患者的优秀预后指标。在本研究中,我们评估了SII在预测接受血管内治疗(EVT)的AIS患者的预后和再灌注状态方面的效用。

患者与方法

123例连续的AIS患者纳入我们的研究。采用受试者操作特征(ROC)曲线确定预测脑再灌注失败的SII临界值。多因素逻辑回归分析分析SII与EVT后再灌注失败率之间的关联。

结果

再灌注失败患者的SII中位数显著高于再灌注成功患者[分别为2,029(1,217 - 2,771)和1,172(680 - 2,145),p = 0.003]。ROC曲线分析表明,预测再灌注失败状态的SII最佳临界值为1,690,敏感性和特异性分别为71%和69%。曲线下面积(AUC)为0.673(95%CI;0.552 - 0.793)。多因素分析表明,SII≥1,690是EVT后脑再灌注失败和不良临床结局的独立预测因素(风险比 - H.R.=3.713,95%CI:1.281 - 10.76,p = 0.016,HR = 2.28,95%CI:1.06 - 4.88,p = 0.035)。

结论

我们认为SII是预测接受EVT的AIS患者脑再灌注失败和不良临床结局的潜在指标。

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