Liu Xingxing, Guo Yikun, Qi Wensheng
Guanganmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Xicheng District, Beijing, China.
Dongzhimen Hospital, Beijing University of Chinese Medicine, Dongcheng District, Beijing, China.
PLoS One. 2025 Jan 24;20(1):e0316390. doi: 10.1371/journal.pone.0316390. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease, and inflammation plays a key role in the pathogenesis of COPD. The aim of this study is to investigate the association between systemic immune inflammation index (SII), systemic inflammatory response index (SIRI),pan-immune inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) and all-cause mortality in patients with chronic obstructive pulmonary disease (COPD), and to evaluate the effect of composite inflammatory markers on the prognosis of COPD patients. We obtained data on COPD patients from the Medical Information Mart for Intensive Care (MIMIC) -IV database and divided patients into four groups based on quartiles of baseline levels of inflammatory markers, The primary outcomes were in-hospital and ICU mortality. We comprehensively explored the association between composite inflammatory markers and mortality in patients with COPD using restricted cubic splints (RCS), COX proportional hazards regression models, Kaplan-Meier curves, receiver operating characteristic (ROC), and subgroup analyses. A total of 1234 COPD patients were included in this study. RCS results showed that SII, SIRI, PLR, PIV and NLR were positively and non-linearly correlated with the increased risk of in-hospital mortality in COPD patients. Multivariate COX regression analysis showed that compound inflammatory markers were independent risk factors for in-hospital mortality in COPD patients. The KM curve results showed that COPD patients with higher SII, SIRI, PLR and PIV had a significantly lower survival probability. 5 kinds of compound between inflammatory markers and mortality in patients with COPD is related to nonlinear correlation, can increase the risk of mortality in patients with COPD is a risk factor for the prognosis of patients with COPD, and may serve as potential biomarkers for clinical COPD risk stratification and treatment management in critical patients.
慢性阻塞性肺疾病（COPD）是一种慢性炎症性肺疾病，炎症在COPD的发病机制中起关键作用。本研究旨在探讨全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）、全免疫炎症值（PIV）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）与慢性阻塞性肺疾病（COPD）患者全因死亡率之间的关联，并评估复合炎症标志物对COPD患者预后的影响。我们从重症监护医学信息数据库（MIMIC）-IV中获取了COPD患者的数据，并根据炎症标志物基线水平的四分位数将患者分为四组，主要结局为住院和ICU死亡率。我们使用受限立方样条（RCS）、COX比例风险回归模型、Kaplan-Meier曲线、受试者工作特征（ROC）和亚组分析全面探讨了复合炎症标志物与COPD患者死亡率之间的关联。本研究共纳入1234例COPD患者。RCS结果显示，SII、SIRI、PLR、PIV和NLR与COPD患者住院死亡率增加的风险呈正相关且为非线性相关。多变量COX回归分析显示，复合炎症标志物是COPD患者住院死亡率的独立危险因素。KM曲线结果显示，SII、SIRI、PLR和PIV较高的COPD患者生存概率显著降低。5种复合炎症标志物与COPD患者死亡率之间呈非线性相关，可增加COPD患者的死亡风险，是COPD患者预后的危险因素，可能作为临床COPD重症患者风险分层和治疗管理的潜在生物标志物。
