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全身炎症在卒中相关性感染及急性缺血性卒中远期预后中的作用：一项中介分析

A Role for Systemic Inflammation in Stroke-Associated Infection and the Long-Term Prognosis of Acute Ischemic Stroke: A Mediation Analysis.

作者信息

Huang Suwen, Xie Wei, Gao Yufan, Jin Yining, Chen Yilin, Zhou Guoliang, Chen Feng, Jin Qiaoqiao, Wu Zihao, Wang Lingsheng, Chen Chao, Weng Yiyun, Chen Guangyong

机构信息

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.

The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, People's Republic of China.

出版信息

J Inflamm Res. 2024 Sep 19;17:6533-6545. doi: 10.2147/JIR.S474344. eCollection 2024.

DOI:10.2147/JIR.S474344
PMID:39318992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11420892/
Abstract

BACKGROUND AND PURPOSE

The dynamic systemic inflammation level and stroke-associated infection (SAI) are related to the prognosis of acute ischemic stroke (AIS). We aimed to explore whether the systemic inflammatory response index (SIRI), systemic immune inflammation index (SII), and their dynamic changes possess predictability for SAI and long-term prognosis.

METHODS

A total of 1804 AIS patients without intravenous thrombolysis in two hospitals were included. We explored the relationship between SIRI, SII, and their dynamic changes and outcomes by constructing clusters. The mediating effects of SAI between prognosis and systemic inflammation were further evaluated.

RESULTS

Each SD increase in the concentration of SIRI exhibited a significant correlation with the risk of poor functional outcome, mortality, and functional dependency. Through K-means clustering analysis, patients with dramatically elevated or decreased systemic inflammation levels of SIRI (OR: 2.293, 95% CI: 1.279-4.109) and SII (OR: 3.165, 95% CI: 1.627-6.156) within 7 days had a higher risk of functional outcome. Through mediation analysis, SAI mediated the association between systemic inflammation and poor prognosis (SIRI: 33.73%, SII: 16.01%).

CONCLUSION

Dramatically changing dynamics of SIRI and SII were significantly associated with a higher risk of poor prognosis in AIS patients. SAI mediated the association between systemic inflammation and prognosis at 1 year.

摘要

背景与目的

动态全身炎症水平和卒中相关感染（SAI）与急性缺血性卒中（AIS）的预后相关。我们旨在探讨全身炎症反应指数（SIRI）、全身免疫炎症指数（SII）及其动态变化是否对SAI和长期预后具有预测性。

方法

纳入两家医院共1804例未接受静脉溶栓治疗的AIS患者。我们通过构建聚类来探讨SIRI、SII及其动态变化与预后之间的关系。进一步评估SAI在预后与全身炎症之间的中介作用。

结果

SIRI浓度每增加1个标准差，与功能预后不良、死亡率和功能依赖风险显著相关。通过K均值聚类分析，7天内SIRI（OR：2.293，95%CI：1.279-4.109）和SII（OR：3.165，95%CI：1.627-6.156）全身炎症水平显著升高或降低的患者功能预后风险更高。通过中介分析，SAI介导了全身炎症与预后不良之间的关联（SIRI：33.73%，SII：16.01%）。

结论

SIRI和SII的显著动态变化与AIS患者预后不良风险显著相关。SAI介导了1年时全身炎症与预后之间的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/db964e30c2c9/JIR-17-6533-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/2a41c4e3665b/JIR-17-6533-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/c7b83bd55be2/JIR-17-6533-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/1a33c76f8252/JIR-17-6533-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/db964e30c2c9/JIR-17-6533-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/2a41c4e3665b/JIR-17-6533-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/c7b83bd55be2/JIR-17-6533-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/1a33c76f8252/JIR-17-6533-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/11420892/db964e30c2c9/JIR-17-6533-g0004.jpg

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