系统免疫炎症指数在脓毒症严重程度和预后判断中的应用价值

Value of systemic immune inflammatory index in judging severity and prognosis of sepsis

目的探讨系统免疫炎症指数(SII)在脓毒症严重程度和预后判断中的应用价值。方法回顾性分析2018年1月至2019年12月浙江省台州市第一人民医院诊治的115例脓毒症患者的临床资料,根据患者是否发生脓毒性休克,将其分为脓毒性休克组(65例)和非脓毒性休克组(50例);根据28 d转归情况,将其分为存活组(85例)和死亡组(30例)。比较不同组间SII、急性生理学和慢性健康状况评估系统(APACHEⅡ)及序贯器官衰竭评估(SOFA)评分。分析SII与APACHEⅡ及SOFA评分的相关性及三者对脓毒症预后的评估价值。结果脓毒性休克组SII、APACHEⅡ及SOFA评分均高于非脓毒性休克组[1455(675,2536)比385(335,496)、(25.3±1.1)分比(10.7±2.2)分、(18.3±5.2)分比(9.3±2.6)分],差异均有统计学意义(均P<0.05)。死亡组SII、APACHEⅡ及SOFA评分均高于存活组[2356(1753,2534)比286(203,913)、(28.3±7.3)分比(16.3±4.3)分、(23.5±12.3)分比(13.2±3.5)分],差异均有统计学意义(均P<0.05)。Pearson相关性分析结果显示,SII与APACHEⅡ及SOFA评分均呈正相关(r=0.562、0.534,均P<0.001)。受试者工作特征曲线分析结果显示,SII评估脓毒症患者预后的曲线下面积大于APACHEⅡ及SOFA评分且敏感度高于APACHEⅡ、SOFA评分。结论SII有助于帮助脓毒症患者病情严重程度及预后的判断,可用作一项评估指标。

Objective To investigate the value of systemic immune inflammatory index(SII)in judging severity and prognosis of sepsis.Methods From January 2018 to December 2019,clinical data of 115 patients with sepsis admitted to Taizhou First People’s Hospital,Zhejiang Province were retrospectively analyzed.According to whether the patients had septic shock,they were divided into septic shock group(65 cases)and non septic shock group(50 cases);according to the outcomes of 28 d,patients were divided into survival group(85 cases)and death group(30 cases).The SII,scores of acute physiology and chronic health evaluation(APACHEⅡ)and sequential organ failure assessment(SOFA)were compared among the different groups.The correlation between SII level and APACHEⅡ,SOFA scores,and the value of those in evaluating the prognosis of sepsis were analyzed.Results The SII,APACHEⅡand SOFA scores in septic shock group were higher than those in non septic shock group[1455(675,2536)vs 385(335,496),(25.3±1.1)vs(10.7±2.2),(18.3±5.2)vs(9.3±2.6)](all P<0.05).The SII,APACHEⅡand SOFA scores in death group were higher than those in survival group[2356(1753,2534)vs 286(203,913),(28.3±7.3)vs(16.3±4.3),(23.5±12.3)vs(13.2±3.5)](all P<0.05).Pearson correlated analysis showed that SII was positively correlated with APACHEⅡand SOFA scores(r=0.562,0.534,both P<0.001).Receiver operating characteristic curve showed that the area under the curve of SII to assess the outcome of sepsis patients was larger than that of APACHEⅡand SOFA scores;the sensitivity of SII was higher than that of APACHEⅡand SOFA scores.Conclusion SII can help to determine the severity and prognosis of patients with sepsis.