系统免疫炎症指数对老年射血分数减低型心力衰竭病人下肢深静脉血栓形成的预测价值

Predictive value of systemic immune-inflammatory index for lower extremity deep venous thrombosis in elderly patients with heart failure with reduced ejection fraction

目的 评价系统免疫炎症指数(SII)对老年射血分数减低型心力衰竭(HFrEF)病人下肢深静脉血栓形成(LEDVT)的预测价值。方法 回顾性分析2020年8月至2022年5月于我院急诊首诊并住院的163例老年HFrEF病人的临床资料。采用单因素和多因素Logistic回归分析筛选HFrEF病人LEDVT发生的独立危险因素,并评价相关因素对LEDVT的预测价值。结果 163例HFrEF病人中,合并LEDVT 32例(19.6%)。与无LEDVT组相比,LEDVT组病人年龄更大,急诊就诊时Autar评分、SII和血浆D-二聚体水平更高(均P<0.05)。多因素Logistic回归分析表明,SII、血浆D-二聚体为LEDVT的独立预测因子。ROC曲线分析表明,SII预测LEDVT的能力最强,AUC为0.782。据SII截断值(629×10^(9)/L)将病人分为SII_(高)组和SII_(低)组,Kaplan-Meier生存曲线分析表明,SII_(高)组LEDVT发生率显著高于SII_(低)组,差异有统计学意义(χ^(2)=9.133,P=0.003)。结论 急诊就诊时SII水平可作为老年HFrEF病人LEDVT的独立预测因子,用其进行危险分层有助于早期识别高危人群。

Objective To evaluate the predictive value of systemic immune-inflammation index(SII) for lower extremity deep venous thrombosis(LEDVT) in the elderly patients with heart failure with reduced ejection fraction(HFrEF).Methods A retrospective study was performed,and a total of 163 elderly HFrEF patients in our hospital from August 2020 to May 2022 were enrolled in this study.The independent risk factors of LEDVT were screened by univariate and multivariate Logistic regression analysis,and the predictive value of the variants for the incidence of LEDVT was evaluated by receiver operating characteristic(ROC) curve.Results Thirty-two cases(19.6%) presented with LEDVT.Compared to the non-LEDVT group,the age,the levels of Autar score,SII and plasma D-dimer at admission were significantly higher in the LEDVT group(P<0.05).Multivariate Logistic regression showed that the level of SII,plasma D-dimer were independent influencing factors of LEDVT.ROC curve showed that SII had significant predictive value for LEDVT with an AUC of 0.782,and the cutoff value of SII was 629×10^(9)/L.Kaplan-Meier survival curve analysis showed that the incidence rate of LEDVT in high SII group(>629×10^(9)/L) was significantly higher than that in low SII group(χ^(2)=9.133,P=0.003).Conclusions SII level at admission can be used as an independent risk predictor of LEDVT in the elderly patients with HFrEF.