全身免疫炎症指数对STEMI患者梗死相关动脉自发再通预测价值

Predictive Value of Systemic Immune Inflammation Index for Spontaneous Recanalization of Infarct-related Arteries in Patients with STEMI

目的探究全身免疫炎症指数(systemic immune-inflammation index,SII)作为一种新型炎症指标对心肌梗死患者梗死相关动脉(infarct-related artery,IRA)自发再通的预测价值。方法连续纳入2021年1~12月就诊于徐州医科大学附属医院急诊科,并于发病12h内行直接经皮冠状动脉介入治疗术治疗的ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者,根据术中显示的冠状动脉造影结果将患者分为自发再通组(n=61)和非自发再通组(n=151)。回顾性分析两组STEMI患者的临床基线资料特征、实验室结果,并采用Logistic回归筛选梗死相关动脉自发再通的影响因素,采用受试者工作特征曲线评价入院SII水平预测梗死相关动脉自发再通的价值。结果两组患者SII、血小板计数与淋巴细胞计数比值、高敏C反应蛋白、谷草转氨酶、左心室射血分数、肌钙蛋白I峰值、超敏肌钙蛋白T峰值等比较,差异有统计学意义(P<0.05)。二元多因素Logistic回归分析显示,SII是IRA自发再通最强的独立预测因子(OR=0.997,95%CI:0.995~0.999,P=0.001)。SII预测IRA自发再通的受试者工作特征曲线曲线下面积为0.826(95%CI:0.764~0.888),截断值为1344.12,此时敏感度为72.2%,特异性为80.3%,具有预测价值(P<0.001)。结论SII可能与STEMI患者IRA自发再通独立相关,并对自发再通有一定的预测价值。

Objective To explore the predictive value of systemic immune inflammation index(SII)as a new inflammatory maker for spontaneous recanalization of infarct-related artery(IRA)in patients with myocardial infarction.Methods STEMI patients who were admitted to Department of Emergency,the affiliated Hospital of Xuzhou Medical University from January 2021 to December 2021 and received direct percutaneous coronary intervention within 12h were selected,they were divided into spontaneous recanalization group(n=61)and non-spontaneous recanalization group(n=151)according to the results of coronary angiography.The clinical baseline data and laboratory results of the two groups of patients with STEMI were analyzed retrospectively,and Logistic regression was used to screen the influencing factors of spontaneous recanalization of IRA.Receiver operating characteristic curve was used to evaluate the predictive value of admission SII level for spontaneous recanalization of IRA.Results There were significant differences in SII,ratio of platelet count to lymphocyte count,high sensitivity C-reactive protein,glutamic-oxaloacetic transaminase,left ventricular ejection fraction,peak value of troponin I and peak value of hypersensitive troponin T between the two groups(P<0.05).Multivariate Logistic regression analysis showed that SII was the strongest independent predictor of spontaneous recanalization of IRA(OR=0.997,95%CI:0.995-0.999,P=0.001).The area under the of receiver operating characteristic cure of IRA spontaneous recanalization predicted by SII was 0.826(95%CI:0.764-0.888),the cut-off value was 1344.12,the sensitivity was 72.2%,and the specificity was 80.3%,which had predictive value(P<0.001).Conclusion SII may be independently related to spontaneous recanalization of IRA in patients with STEMI,and has a certain predictive value for spontaneous recanalization.