Kwok Wang Chun, Tam Terence Chi Chun, Lam David Chi Leung, Ip Mary Sau Man, Ho James Chung Man
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
J Thorac Dis. 2024 May 31;16(5):2767-2775. doi: 10.21037/jtd-23-1392. Epub 2024 May 8.
Bronchiectasis is a common respiratory disease with neutrophilic inflammation being the predominant pathophysiology. Systemic immune-inflammation index (SII) is a simple and readily available biomarker being studied in various conditions including asthma, chronic obstructive pulmonary disease, and interstitial lung disease, but not in bronchiectasis. We aim to investigate the prognostic role of SII in bronchiectasis with this study.
A retrospective cohort study in Chinese patients with non-cystic fibrosis (CF) bronchiectasis was conducted in Hong Kong, to investigate the association between baseline SII and of hospitalized bronchiectasis exacerbation risk over 4.5 years of follow-up, as well as correlating with disease severity in bronchiectasis. The baseline SII in 2018 was calculated based on stable-state complete blood count.
Among 473 Chinese patients with non-CF bronchiectasis were recruited, 94 of the patients had hospitalized bronchiectasis exacerbation during the follow-up period. Higher SII was associated with increased hospitalized bronchiectasis exacerbation risks with adjusted odds ratio (aOR) of 1.001 [95% confidence interval (CI): 1.000-1.001, P=0.003] for 1 unit (cells/µL) increase in SII count and aOR of 1.403 (95% CI: 1.126-1.748, P=0.003) for 1 standard deviation (SD) increase in SII. SII was found to have significant negative association with baseline forced expiratory volume in the first second (FEV) (in litre and percentage predicted), forced vital capacity (FVC) in percentage; and significant positive correlation with the extent of bronchiectasis and baseline neutrophil to lymphocyte ratio (NLR).
SII could serve as biomarker to predict the risks of hospitalized exacerbation in bronchiectasis patients, as well as correlating with the disease severity.
支气管扩张是一种常见的呼吸系统疾病,中性粒细胞炎症是其主要的病理生理学特征。全身免疫炎症指数(SII)是一种简单且易于获得的生物标志物,已在包括哮喘、慢性阻塞性肺疾病和间质性肺疾病等多种疾病中进行研究,但尚未在支气管扩张中进行研究。我们旨在通过本研究探讨SII在支气管扩张中的预后作用。
在香港对中国非囊性纤维化(CF)支气管扩张患者进行了一项回顾性队列研究,以调查基线SII与4.5年随访期间住院支气管扩张加重风险之间的关联,以及与支气管扩张疾病严重程度的相关性。2018年的基线SII基于稳态全血细胞计数计算得出。
共招募了473例中国非CF支气管扩张患者,其中94例患者在随访期间出现住院支气管扩张加重。SII升高与住院支气管扩张加重风险增加相关,SII计数每增加1个单位(细胞/微升),调整后的优势比(aOR)为1.001[95%置信区间(CI):1.000 - 1.001,P = 0.003];SII每增加1个标准差(SD),aOR为1.403(95%CI:1.126 - 1.748,P = 0.003)。发现SII与第一秒用力呼气量(FEV)(以升和预测百分比表示)、用力肺活量(FVC)百分比的基线值呈显著负相关;与支气管扩张程度和基线中性粒细胞与淋巴细胞比值(NLR)呈显著正相关。
SII可作为预测支气管扩张患者住院加重风险的生物标志物,且与疾病严重程度相关。