系统性免疫炎症指数联合单核细胞与高密度脂蛋白胆固醇比值对急性一氧化碳中毒心肌损伤的早期预测作用

Role of systemic immune-inflammation index combined with monocyte to high density lipoprotein-cholesterol ratio in predicting myocardial injury after acute carbon monoxide poisoning

目的探讨系统性免疫炎症指数(SII)联合单核细胞与高密度脂蛋白胆固醇比值(MHR)对急性一氧化碳中毒(ACOP)患者心肌损伤的早期预测作用。方法选择2020年1月至2022年3月河北医科大学哈励逊国际和平医院急救医学部、河北大学附属医院急诊医学科和华北理工大学附属医院急诊科收治的113例ACOP患者,分为心肌损伤组(30例)和非心肌损伤组(83例)。在入院时和入院后12 h检测SII、MHR、CRP、心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)水平。通过logistic回归方法分析ACOP发生心肌损伤的独立危险因素,利用ROC曲线探讨SII、MHR和两者联合检测对ACOP患者发生心肌损伤的早期预测价值。结果入院时心肌损伤组患者的SII、MHR、CRP均高于非心肌损伤组,入院后12 h心肌损伤组患者的SII、MHR、CRP、c TnI和CK-MB均高于非心肌损伤组(P均<0.001)。入院时SII、MHR和CRP水平升高是ACOP患者发生心肌损伤的危险因素(OR=7.248、5.733、2.496,P均<0.05)。入院时ACOP患者SII与MHR联合检测预测心肌损伤的AUC、灵敏度和特异度较高,分别为0.876、0.867和0.766。结论SII与MHR联合检测对ACOP患者发生心肌损伤有一定的早期预测价值。

Objective To explore the role of systemic immune-inflammation index(SII)combined with monocyte to high density lipoprotein-cholesterol ratio(MHR)in predicting myocardial injury in patients with acute carbon monoxide poisoning(ACOP).Methods A total of 113 ACOP patients who were admitted to Department of Emergency of Harrison International Peace Hospital Affiliated to Hebei Medical University,Department of Emergency of Affiliated Hospital of Hebei University,and Department of Emergency of North China University of Science and Technology Affiliated Hospital from Jan.2020 to Mar.2022 were enrolled and divided into myocardial injury group(n=30)and non-myocardial injury group(n=83).The levels of SII,MHR,C reactive protein(CRP),cardiac troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)were detected at admission and 12 h after admission.The independent risk factors of myocardial injury in ACOP patients were analyzed by logistic regression.The early predictive values of SII,MHR and their combination for myocardial injury in ACOP patients were analyzed by receiver operating characteristic curves.Results The levels of SII,MHR and CRP of patients in the myocardial injury group were higher than those in the non-myocardial injury group at admission,and the levels of SII,MHR,CRP,cTnI and CK-MB of patients in the myocardial injury group were higher than those in the nonmyocardial injury group at 12 h after admission(all P<0.001).The elevated levels of SII,MHR and CRP were risk factors for myocardial injury in ACOP patients(odds ratio=7.248,5.733,2.496,all P<0.05).The AUC value,sensitivity and specificity of SII combined with MHR were higher in predicting myocardial injury in ACOP patients at admission(0.876,0.867 and 0.766,respectively).Conclusion The combination of SII and MHR has early predictive value for myocardial injury in ACOP patients.