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基于全身炎症反应指数(SIRI)评估ST段抬高型心肌梗死(STEMI)患者PCI成功后发生肺炎的风险

Systemic inflammation response index (SIRI)-based risk of pneumonia following successful PCI in STEMI patients.

作者信息

Yan Dan, Wang Saibin

机构信息

Department of Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, China.

出版信息

Ann Med. 2025 Dec;57(1):2462449. doi: 10.1080/07853890.2025.2462449. Epub 2025 Feb 5.

Abstract

BACKGROUND

In patients with ST-elevation myocardial infarction (STEMI), pulmonary infection after successful primary percutaneous coronary intervention (PCI) is a severe complication that often results in death. It is not known whether there are any predictive markers for the onset of pneumonia in STEMI patients after successful PCI.

METHODS

According to whether pneumonia occurred within two weeks of PCI, 619 STEMI patients were divided into pneumonia and nonpneumonia groups. The area under the receiver operating characteristic curve (AUC) was used to assess the predictive accuracy of the SIRI for pneumonia risk following successful PCI. Using a restricted cubic spline (RCS) and multivariate regression analysis, we investigated the relationship between the SIRI and PCI-induced pneumonia.

RESULTS

Patients in the pneumonia group had a significantly greater SIRI than did those in the nonpneumonia group at admission (7.81 ± 7.53 vs. 3.35 ± 3.08,  < 0.001). Patients in the SIRI ≥ 4.04 group exhibited greater vulnerability to pneumonia after successful PCI than did those in the SIRI < 4.04 group (OR: 5.20, 95% CI: 3.53-7.72,  < 0.001). According to the ROC curve, the SIRI is highly predictive of pneumonia after PCI for STEMI patients, with an AUC of 0.766 (95% CI: 0.724-0.808). As the SIRI increased, the pneumonia risk increased in the RCS model.

CONCLUSION

As a result of PCI for STEMI patients, the SIRI is a good indicator of pneumonia risk. The likelihood of pneumonia occurring in STEMI patients after PCI generally increases with increasing SIRI.

摘要

背景

在ST段抬高型心肌梗死(STEMI)患者中,直接经皮冠状动脉介入治疗(PCI)成功后的肺部感染是一种严重并发症,常导致死亡。目前尚不清楚PCI成功后STEMI患者发生肺炎是否存在任何预测标志物。

方法

根据PCI术后两周内是否发生肺炎,将619例STEMI患者分为肺炎组和非肺炎组。采用受试者操作特征曲线(AUC)下面积评估PCI成功后SIRI对肺炎风险的预测准确性。使用受限立方样条(RCS)和多因素回归分析,我们研究了SIRI与PCI诱发肺炎之间的关系。

结果

肺炎组患者入院时的SIRI显著高于非肺炎组(7.81±7.53 vs. 3.35±3.08,<0.001)。PCI成功后,SIRI≥4.04组患者比SIRI<4.04组患者更易发生肺炎(OR:5.20,95%CI:3.53-7.72,<0.001)。根据ROC曲线,SIRI对STEMI患者PCI术后肺炎具有较高的预测价值,AUC为0.766(95%CI:0.724-0.808)。在RCS模型中,随着SIRI的增加,肺炎风险增加。

结论

对于接受PCI治疗的STEMI患者,SIRI是肺炎风险的良好指标。PCI术后STEMI患者发生肺炎的可能性通常随着SIRI的增加而增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6080/11800334/98263b13fbea/IANN_A_2462449_F0001_B.jpg

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