Li Guanglan, Yu Jing, Jiang Simin, Wu Kefei, Xu Yiping, Lu Xiaohui, Wang Yating, Lin Jianxiong, Yang Xiao, Li Zhibin, Mao Haiping
Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, 510080, China.
J Inflamm Res. 2023 Aug 31;16:3871-3878. doi: 10.2147/JIR.S426961. eCollection 2023.
The prognosis of patients receiving peritoneal dialysis (PD) is associated with inflammation. Systemic immune-inflammation index (SII) is one of inflammatory markers, and the role in predicting clinical outcomes in PD patients is unclear. We aimed to investigate the relationship between the SII and all-cause and cardiovascular-specific mortalities in patients undergoing PD.
A total of 1419 PD patients from the First Affiliated Hospital of Sun Yat-sen University between January 1, 2007 and December 31, 2019 were retrospectively included at baseline, and the patients were followed up until November 31, 2021. SII was calculated as platelet count×neutrophil count/lymphocyte count. Kaplan-Meier curves and Cox proportional hazards regression models were used to determine the relationship between SII levels and all-cause and cardiovascular-specific mortalities.
During follow-up (median period was 42 months), 321 patients died (171 died of cardiovascular disease). With adjustment for the potential confounding factors, each 1-SD increase in the SII was associated with 20.2% increase in all-cause mortality (hazard ratio [HR]: 1.202, 95% confidence interval [CI]: 1.088-1.327, <0.001) and 28.0% increase in cardiovascular-specific mortality (HR: 1.280, 95% CI: 1.126-1.456, <0.001). High SII (vs low SII) was significantly associated with increased risks of all-cause mortality (HR: 1.391, 95% CI: 1.066-1.815, -value: 0.015) and cardiovascular-specific mortality (HR: 1.637, 95% CI: 1.185-2.261, -value: 0.003). Subgroups analyses showed similar results for those younger than 65-year-old only.
Elevated SII level was independently associated with increased risks of all-cause and cardiovascular-specific mortalities in PD patients, especially for those younger than 65-year-old.
接受腹膜透析(PD)的患者的预后与炎症相关。全身免疫炎症指数(SII)是炎症标志物之一,其在预测PD患者临床结局中的作用尚不清楚。我们旨在研究SII与接受PD治疗的患者全因死亡率和心血管特异性死亡率之间的关系。
回顾性纳入2007年1月1日至2019年12月31日期间中山大学附属第一医院的1419例PD患者作为基线研究对象,并对患者进行随访至2021年11月31日。SII的计算方法为血小板计数×中性粒细胞计数/淋巴细胞计数。采用Kaplan-Meier曲线和Cox比例风险回归模型来确定SII水平与全因死亡率和心血管特异性死亡率之间的关系。
在随访期间(中位时间为42个月),321例患者死亡(171例死于心血管疾病)。在对潜在混杂因素进行校正后,SII每增加1个标准差,全因死亡率增加20.2%(风险比[HR]:1.202,95%置信区间[CI]:1.088-1.327,P<0.001),心血管特异性死亡率增加28.0%(HR:1.280,95%CI:1.126-1.456,P<0.001)。高SII(与低SII相比)与全因死亡率增加的风险显著相关(HR:1.391,95%CI:1.066-1.815,P值:0.015)和心血管特异性死亡率增加的风险显著相关(HR:1.637,95%CI:1.185-2.261,P值:0.003)。亚组分析显示,仅在65岁以下的患者中结果相似。
SII水平升高与PD患者全因死亡率和心血管特异性死亡率增加的风险独立相关,尤其是在65岁以下的患者中。