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血管内治疗后颅内动脉瘤性蛛网膜下腔出血(aSAH)患者较高的全身免疫炎症指数(SII)与深静脉血栓形成(DVT)之间的关联。

Association between higher systemic immune inflammation index (SII) and deep vein thrombosis (DVT) in patients with aneurysmal subarachnoid hemorrhage (aSAH) after endovascular treatment.

机构信息

Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.

Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.

出版信息

Neurosurg Rev. 2023 Jun 20;46(1):142. doi: 10.1007/s10143-023-02048-7.

Abstract

Inflammation contributes to deep vein thrombosis (DVT) formation in patients with aSAH after endovascular treatment. The relationship between systemic immune-inflammatory index (SII) as an inflammatory marker and DVT formation remains unclear. Thus, this study aims to evaluate the association between SII and aSAH-associated DVT following endovascular treatment. We enrolled 562 consecutive patients with aSAH after endovascular treatment at three centers from January 2019 to September 2021. The endovascular treatments included simple coil embolization and stent-assisted coil embolization. Deep venous thrombosis (DVT) was assessed by Color Doppler ultrasonography (CDUS). Multivariate logistic regression analysis was used to establish the model. We assessed the association of the SII, neutrophil-to-lymphocyte ratio (NLR), the systemic inflammatory response index (SIRI), platelet-lymphocyte ratio (PLR), and DVT by using restricted cubic spline (RCS). ASAH-associated DVT was found in 136 (24.20%) patients. Based on the multiple logistic regression analysis, the correlation was found between aSAH-associated DVT and elevated SII (fourth quartile) (adjusted odds ratio = 8.20 [95% confidence interval, 3.76-17.92]; p < 0.001 [p for trend < 0.001]), elevated NLR (fourth quartile) (adjusted odds ratio = 6.94 [95% confidence interval, 3.24-14.89]; p < 0.001 [p for trend < 0.001]), elevated SIRI (fourth quartile) (adjusted odds ratio = 4.82 [95% confidence interval, 2.36-9.84]; p < 0.001 [p for trend < 0.001]), and elevated PLR (fourth quartile) (adjusted odds ratio = 5.49 [95% confidence interval, 2.61-11.57]; p < 0.001 [p for trend < 0.001]). The increased SII was correlated with the formation of aSAH-associated DVT after endovascular treatment.

摘要

炎症是血管内治疗后蛛网膜下腔出血(aSAH)患者深静脉血栓(DVT)形成的原因。全身性免疫炎症指数(SII)作为炎症标志物与 DVT 形成之间的关系尚不清楚。因此,本研究旨在评估血管内治疗后 SII 与 aSAH 相关 DVT 的关系。我们纳入了 2019 年 1 月至 2021 年 9 月在三个中心接受血管内治疗的 562 例 aSAH 患者。血管内治疗包括单纯线圈栓塞和支架辅助线圈栓塞。采用彩色多普勒超声(CDUS)评估深静脉血栓(DVT)。多变量逻辑回归分析用于建立模型。我们使用限制性立方样条(RCS)评估 SII、中性粒细胞与淋巴细胞比值(NLR)、全身炎症反应指数(SIRI)、血小板与淋巴细胞比值(PLR)与 DVT 的相关性。发现 136 例(24.20%)患者存在 aSAH 相关 DVT。基于多变量逻辑回归分析,aSAH 相关 DVT 与 SII 升高(第四四分位数)(校正比值比=8.20[95%置信区间,3.76-17.92])、NLR 升高(第四四分位数)(校正比值比=6.94[95%置信区间,3.24-14.89])、SIRI 升高(第四四分位数)(校正比值比=4.82[95%置信区间,2.36-9.84])和 PLR 升高(第四四分位数)(校正比值比=5.49[95%置信区间,2.61-11.57])相关(p<0.001[趋势 p<0.001])。升高的 SII 与血管内治疗后 aSAH 相关 DVT 的形成相关。

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