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全血细胞计数衍生的炎症指标对肥厚型心肌病患者慢性肾脏病风险的预测作用

Effect of CBC-Derived Inflammatory Indicators in Predicting Chronic Kidney Disease Risk in Hypertrophic Cardiomyopathy Patients.

作者信息

Zhao Changying, Yan Luqin, Liu Yong, Chen Siyuan, Lan Beidi, Liu Ruohan, Xin Jinqi, Shi Tao, Yang Xiaohong

机构信息

Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China.

Intensive Care Unit of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710114, China.

出版信息

Biomedicines. 2025 Apr 20;13(4):997. doi: 10.3390/biomedicines13040997.

Abstract

Hypertrophic cardiomyopathy (HCM) is a prevalent condition that often coexists with chronic kidney disease (CKD), significantly impacting patient prognosis. This study aimed to investigate the predictive value of complete blood cell counts derived inflammatory indicators in assessing CKD risk in HCM patients. This study enrolled HCM patients and categorized them into CKD and non-CKD group based on discharge diagnoses. Analyzed indicators included systemic inflammation response index (SIRI), systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Least absolute shrinkage and selection operator (LASSO) logistic and multivariable logistic regression were employed to identified independent risk factors for CKD, which were subsequently utilized to develop a nomogram. A total of 1795 HCM patients were included, including 112 (6.24%) individuals assigned to the CKD group. In univariate analyses, NLR (AUC: 0.755; 95%CI: 0.711-0.800) demonstrated superior accuracy compared to others. Eighteen baseline characteristics exhibiting statistical difference were incorporated into LASSO-logistic regression. Six factors were further selected by multivariable logistic regression. The results identified male gender (OR: 2.622; 95% CI: 1.565-4.393, < 0.001), Hb (OR: 0.972; 95% CI: 0.962-0.981, < 0.001), Pro-BNP (OR: 1.000; 95% CI: 1.000-1.000, < 0.001), SIRI (OR: 1.037; 95% CI: 1.026-1.049, < 0.001), and SII (OR: 1.000; 95% CI: 1.000-1.001, = 0.003) as risk factors. These five factors were used to construct a nomogram, which exhibited good accuracy and consistency. Male gender, Hb, Pro-BNP, SIRI, and SII were identified as risk factors for CKD risk in HCM patients. A nomogram was developed using these factors, which may facilitate early identification and management of high-risk individuals.

摘要

肥厚型心肌病(HCM)是一种常见疾病,常与慢性肾脏病(CKD)共存,对患者预后有重大影响。本研究旨在探讨全血细胞计数衍生的炎症指标在评估HCM患者CKD风险中的预测价值。本研究纳入了HCM患者,并根据出院诊断将他们分为CKD组和非CKD组。分析的指标包括全身炎症反应指数(SIRI)、全身免疫炎症指数(SII)、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)。采用最小绝对收缩和选择算子(LASSO)逻辑回归和多变量逻辑回归来确定CKD的独立危险因素,随后利用这些因素构建列线图。共纳入1795例HCM患者,其中112例(6.24%)被分配到CKD组。在单变量分析中,NLR(AUC:0.755;95%CI:0.711 - 0.800)显示出比其他指标更高的准确性。将18个具有统计学差异的基线特征纳入LASSO逻辑回归。通过多变量逻辑回归进一步选择了6个因素。结果确定男性性别(OR:2.622;95%CI:1.565 - 4.393,<0.001)、血红蛋白(Hb)(OR:0.972;95%CI:0.962 - 0.981,<0.001)、脑钠肽前体(Pro - BNP)(OR:1.000;95%CI:1.000 - 1.000,<0.001)、SIRI(OR:1.037;95%CI:1.026 - 1.049,<0.001)和SII(OR:1.000;95%CI:1.000 - 1.001,=0.003)为危险因素。利用这五个因素构建了列线图,该列线图显示出良好的准确性和一致性。男性性别、Hb、Pro - BNP、SIRI和SII被确定为HCM患者CKD风险的危险因素。利用这些因素开发了一个列线图,这可能有助于早期识别和管理高危个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9b9/12024573/c0a1cfef1c43/biomedicines-13-00997-g001.jpg

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