系统免疫炎症指数与冠心病预后关系的Meta分析

The relationship between systemic immune inflammatory index and prognosis of coronary heart disease: a meta-analysis

目的 系统评价系统免疫炎症指数(SII)与冠心病预后的关系。方法 计算机检索CNKI、VIP、CBM、WanFang Data、PubMed、EMbase、Web of Science、Ovid、Cochrane Library和Scopus数据库,搜集关于SII对冠心病患者预后影响的队列研究,检索时限均从建库至2022年12月10日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件和Stata 15.0软件进行Meta分析。结果 共纳入7个队列研究,包括18 413例患者。Meta分析结果显示:与低水平SII相比,高水平SII组冠心病患者主要心血管不良事件(MACE)[OR=2.23,95%Cl(1.51,3.30),P<0.01]、全因死亡[OR=1.95,95%Cl(1.11,3.40),P=0.02]、心源性死亡[OR=2.39,95%Cl(1.47,3.90),P<0.01]的发生风险更高,差异有统计学意义。但两组在心衰再住院发生风险的差异无统计学意义。结论 当前证据表明,高水平SII可能与冠心病患者的MACE、全因死亡和心源性死亡风险增加有关。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the relationship between systemic immune inflammatory index(SII) and the prognosis of coronary heart disease. Methods The CNKI, VIP, CBM, WanFang Data, PubMed, EMbase,Web of Science, Ovid, Cochrane Library and Scopus databases were electronically searched to collect cohort studies related to the relationship between SII and the prognosis of patients with coronary heart disease from inception to December 10, 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 15.0 software. Results A total of 7 cohort studies involving 18 413 patients were included. The results of meta-analysis showed that the group of high level SII was higher risk of major adverse cardiovascular events(MACE)(OR=2.2, 95%Cl 1.5 to 3.3, P<0.01), all-cause death(OR=2.0, 95%Cl 1.1 to 3.4, P=0.02), and cardiogenic death(OR=2.4, 95%Cl 1.5 to 3.9, P<0.01) than the group of low level SII. However, no significant difference was found in the risk of re-hospitalization for heart failure. Conclusion The current evidence shows that high levels of SII can increase the risk of MACE, all-cause death and cardiogenic death in patients with coronary heart disease. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.