Xue Bo, Wang Zeyu, Li Jianguo
Shanxi Medical University, Taiyuan, Shanxi Province, China.
Fuwai Hospital Chinese Academy of Medical Sciences, Bei Jing, China.
J Infect Dev Ctries. 2025 Feb 28;19(2):315-324. doi: 10.3855/jidc.19636.
This study investigates the association between high-level systemic immune-inflammatory index (SII) and cirrhosis progression in patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD).
A total of 272 CHB patients with NAFLD treated at Jincheng General Hospital between January 2018 and January 2023 were included. The study endpoint was the development of cirrhosis. The optimal SII cut-off value for predicting cirrhosis progression was determined as 1024 using ROC curve analysis and Youden index. Based on this cut-off, patients were classified into low SII (n = 159) and high SII (n = 113) groups. Univariate and multivariate Cox regression analyses were performed to identify independent predictors of cirrhosis progression and assess the relationship with SII.
Univariate Cox analysis revealed that SII was a significant risk factor for cirrhosis progression in CHB with NAFLD (HR = 2.062, 95% CI: 1.717-3.941, p < 0.001). Multivariate Cox regression analysis demonstrated a significant association between elevated SII levels and increased incidence of cirrhosis, with patients in the high SII group having an 88.5% higher risk (HR = 1.885, 95% CI: 1.167-3.045, p = 0.010). Kaplan-Meier survival analysis further confirmed the higher risk of cirrhosis in patients with high SII levels (log-rank p < 0.001) within 60 months.
This study suggests that SII is a relevant risk factor for cirrhosis development in CHB individuals with NAFLD, emphasizing the importance of considering SII in current clinical management.
本研究调查了慢性乙型肝炎（CHB）和非酒精性脂肪性肝病（NAFLD）患者中高水平全身免疫炎症指数（SII）与肝硬化进展之间的关联。
纳入2018年1月至2023年1月在晋城总医院接受治疗的272例合并NAFLD的CHB患者。研究终点为肝硬化的发生。使用ROC曲线分析和尤登指数确定预测肝硬化进展的最佳SII临界值为1024。基于此临界值，患者被分为低SII组（n = 159）和高SII组（n = 113）。进行单因素和多因素Cox回归分析以确定肝硬化进展的独立预测因素，并评估与SII的关系。
单因素Cox分析显示，SII是合并NAFLD的CHB患者肝硬化进展的显著危险因素（HR = 2.062，95%CI：1.717 - 3.941，p < 0.001）。多因素Cox回归分析表明，SII水平升高与肝硬化发病率增加之间存在显著关联，高SII组患者的风险高88.5%（HR = 1.885，95%CI：1.167 - 3.045，p = 0.010）。Kaplan-Meier生存分析进一步证实，在60个月内，高SII水平患者发生肝硬化的风险更高（对数秩检验p < 0.001）。
本研究表明，SII是合并NAFLD的CHB患者发生肝硬化的相关危险因素，强调了在当前临床管理中考虑SII的重要性。
