全身免疫炎症指数与腹膜透析相关性腹膜炎治疗失败的关系

The relationship between systemic immunoinflammatory index and treatment failure of peritoneal dialysis-associated peritonitis

目的探讨全身免疫炎症指数(systemic immune-inflammation index,SII)与腹膜透析相关性腹膜炎(peritoneal dialysis-associated peritonitis,PDAP)治疗失败的关系。方法回顾性分析2015年1月—2022年12月在宁波大学附属第一医院腹膜透析中心治疗的PDAP患者的临床资料,根据治疗是否成功分为治疗成功组和治疗失败组。比较2组患者的基线临床资料及实验室资料,采用Logistic回归法分析SII与PDAP治疗失败的关系,通过绘制受试者工作特征曲线(ROC曲线)分析SII对PDAP治疗失败的预测价值。结果共纳入87例PDAP患者,男60例(69.0%),治疗成功组63例,治疗失败组24例。与治疗成功组相比较,治疗失败组年龄更大(t=-2.643,P=0.010),白蛋白(t=2.189,P=0.031)、前白蛋白(t=2.189,P=0.031)更低,超敏C反应蛋白(Z=-2.821,P=0.005)和SII水平(Z=-2.934,P=0.003)更高。多因素Logistic回归分析结果显示:高SII水平是PDAP治疗失败的独立影响因素(OR=1.001,95%CI:1.000~1.002,P=0.047)。ROC曲线结果显示SII预测PDAP治疗失败的曲线下面积为0.704(95%CI:0.579~0.829,P=0.003),最佳截断值为2463.23时,敏感性为46.0%,特异性为92.1%。结论高SII水平与PDAP治疗失败独立相关,可作为预测PDAP治疗失败的良好标志物。

Objective To explore the relationship between systemic immunoinflammation index(SII)and treatment failure of peritoneal dialysis-associated peritonitis(PDAP).Methods The clinical data of PDAP patients treated in the Peritoneal Dialysis Center of the First Affiliated Hospital of Ningbo University from January 2015 to December 2022 were retrospectively analyzed.They were divided into successful treatment group and failed treatment group according to the treatment results.The baseline clinical and laboratory data were compared between the two groups.Logistic regression was used to evaluate the relationship between SII and PDAP treatment failure.Receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of SII for PDAP treatment failure.Results This study recruited 87 patients with PDAP,in which 60(69.0%)were males,and 63 patients were in the successful treatment group and 24 patients were in the failed treatment group.Compared with the successful treatment group,patients in the failed treatment group had older age(t=-2.643,P=0.010),lower albumin(t=2.189,P=0.031),lower prealbumin(t=2.189,P=0.031),higher hypersensitive C-reactive protein(Z=-2.821,P=0.005)and higher SII level(Z=-2.934,P=0.003).Multivariate logistic regression demonstrated that higher SII was the independent factor for treatment failure of PDAP(OR=1.001,95%CI:1.000~1.002,P=0.047).ROC curve results showed that the area under the curve of SII for predicting treatment failure of PDAP was 0.704(95%CI:0.579~0.829,P=0.003);when the optimal cut-off SII value was set at 2463.23,the sensitivity was 46.0%and the specificity was 92.1%.Conclusion High SII is independently associated with treatment failure of PDAP.Therefore,SII can be used as a better biomarker to predict treatment failure of PDAP.