Wu Wen, Zhang Yupei, Zhang Yilan, Qu Xingguang, Zhang Zhaohui, Zhang Rong
Department of Emergency and Critical Care Medicine, Yichang Central People's Hospital, Yichang, Hubei, 443003, People's Republic of China.
The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People's Republic of China.
J Inflamm Res. 2025 Mar 27;18:4471-4480. doi: 10.2147/JIR.S512553. eCollection 2025.
This study aimed to determine the association of the systemic inflammatory response index (SIRI) with severity in patients with acute pancreatitis (AP).
This retrospective study was conducted using clinical data of 1514 patients with AP who were admitted between January 2019 and October 2023 to the First Clinical Medical College of Three Gorges University. SIRI was calculated as peripheral blood neutrophils × monocytes/lymphocytes ratio, and patients were divided into tertiles according to the SIRI levels. The comparison of demographic characteristics, clinical manifestations, laboratory parameters, and outcomes was made among groups. We also carried out multivariate logistic regression to analyze risk factors independently and forecast AP severity. Furthermore, the relationship between SIRI and AP severity was assessed using restricted cubic spline analysis. Subgroup analysis was conducted according to age, sex, body mass index, diabetes, white blood cell count, sequential organ failure assessment score, requirement for continuous renal replacement therapy, and etiology of AP.
Among the 1514 enrolled patients, 171 (11.3%) developed severe AP. Higher SIRI levels were independently related to the higher incidence of severe AP (adjusted P < 0.05) after adjusting the possible confounders. Nonlinear curve fitting demonstrated the reverse J-shaped relationship of SIRI with AP severity, with inflection points at 13. A consistent association was observed across various subgroup analyses.
SIRI independently forecasts the severity of AP. This readily available biomarker may facilitate early stratification of risk and prompt intervention in clinical practice.
本研究旨在确定全身炎症反应指数（SIRI）与急性胰腺炎（AP）患者病情严重程度之间的关联。
本回顾性研究采用三峡大学第一临床医学院2019年1月至2023年10月收治的1514例AP患者的临床资料。SIRI计算为外周血中性粒细胞×单核细胞/淋巴细胞比值，并根据SIRI水平将患者分为三分位数。对各组的人口统计学特征、临床表现、实验室参数和结局进行比较。我们还进行了多因素逻辑回归分析，以独立分析危险因素并预测AP的严重程度。此外，使用受限立方样条分析评估SIRI与AP严重程度之间的关系。根据年龄、性别、体重指数、糖尿病、白细胞计数、序贯器官衰竭评估评分、持续肾脏替代治疗需求和AP病因进行亚组分析。
在1514例纳入研究的患者中，171例（11.3%）发生了重症AP。在调整可能的混杂因素后，较高的SIRI水平与重症AP的较高发生率独立相关（校正P<0.05）。非线性曲线拟合显示SIRI与AP严重程度呈反向J形关系，拐点为13。在各种亚组分析中均观察到一致的关联。
SIRI可独立预测AP的严重程度。这种易于获得的生物标志物可能有助于在临床实践中进行早期风险分层和及时干预。
