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全身免疫炎症指数和全身炎症反应指数对急性缺血性卒中危重症患者功能状态及死亡率的预后价值

Prognostic Value of Systemic Immune-Inflammation Index and Systemic Inflammatory Response Index on Functional Status and Mortality in Patients with Critical Acute Ischemic Stroke.

作者信息

Arslan Kadir, Sahin Ayca Sultan

机构信息

University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Anesthesiology and Reanimation.

出版信息

Tohoku J Exp Med. 2025 Mar 15;265(2):91-97. doi: 10.1620/tjem.2024.J094. Epub 2024 Sep 12.

Abstract

Neuroinflammation plays an essential role in the pathogenesis of acute ischemic stroke (AIS). This study aims to investigate the predictive value of the systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) on mortality and functional limitation in patients with critical AIS. Patients with critical AIS in a tertiary hospital's intensive care unit (ICU) between June 2020 and 2022 were retrospectively examined. Patients were classified according to their 28-day mortality (survivor and non-survivor group) and functional status (poor and good functional outcomes). The performances of SII and SIRI in predicting mortality and functional outcomes were compared. A total of 198 patients were included in the study. The median age of the entire population was 70 (56-86) years, and 52% (n = 103) were male. Coronary vascular disease/heart failure was found to be significantly higher in the mortality group (p = 0.025). While SII was found to be significantly higher in the mortality group (1,180 vs. 811, p = 0.038), SIRI did not show a significant difference (1.82 vs. 1.70, p = 0.257). SII and SIRI were significantly higher in the poor functional outcome group (p < 0.001 and p = 0.015). In the ROC analysis of the functional status prediction performances of SII and SIRI, the cut-off value of SII was ≥ 1,146, the area under the curve (AUC) = 0.645 (0.568-0.722), the cut-off value of SIRI was ≤ 2.54, AUC = 0.600 (0.520-0.680) was detected. SII helps predict 28-day mortality in patients with critical AIS. Both SII and SIRI can predict functional status at discharge.

摘要

神经炎症在急性缺血性卒中(AIS)的发病机制中起重要作用。本研究旨在探讨全身免疫炎症指数(SII)和全身炎症反应指数(SIRI)对重症AIS患者死亡率和功能受限的预测价值。对2020年6月至2022年期间某三级医院重症监护病房(ICU)的重症AIS患者进行回顾性研究。根据患者28天死亡率(存活组和非存活组)和功能状态(功能结局差和良好)进行分类。比较SII和SIRI在预测死亡率和功能结局方面的表现。本研究共纳入198例患者。总体人群的中位年龄为70(56 - 86)岁,52%(n = 103)为男性。发现死亡组中冠状动脉疾病/心力衰竭显著更高(p = 0.025)。虽然发现死亡组中SII显著更高(1180对811,p = 0.038),但SIRI未显示出显著差异(1.82对1.70,p = 0.257)。功能结局差的组中SII和SIRI显著更高(p < 0.001和p = 0.015)。在SII和SIRI功能状态预测表现的ROC分析中,SII的临界值为≥1146,曲线下面积(AUC) = 0.645(0.568 - 0.722),SIRI的临界值为≤2.54,检测到AUC = 0.600(0.520 - 0.680)。SII有助于预测重症AIS患者的28天死亡率。SII和SIRI均可预测出院时的功能状态。

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