系统免疫炎症指数与血液透析患者抑郁状态的相关性研究

The correlation between systemic immune inflammation index and depressive state in hemodialysis patients

目的探讨维持性血液透析(MHD)患者抑郁状态与系统免疫炎症指数(SII)的相关性。方法选取2023年2月—6月于北京中西医结合医院血液透析室规律透析的MHD患者73例作为研究对象,根据医院焦虑和抑郁量表(HADS)评分,将患者分为非抑郁组41例和抑郁组32例,分别进行组间比较、单因素、多因素Logistic回归分析MHD患者抑郁的独立危险因素,受试者工作特征曲线(ROC)评估SII对MHD患者抑郁症状的预测价值。结果抑郁组身体质量指数(BMI)、血小板计数(PLT)、白蛋白(ALB)、SII显著高于非抑郁组,教育年限、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)显著低于非抑郁组(P<0.05)。多因素Logistic回归显示SII四分位数是MHD患者抑郁状态的独立危险因素,其中SII为692.82~1128.6的MHD患者抑郁风险是SII≤542.5的8.346倍(P<0.05),SII>1128.6的MHD患者抑郁风险是SII≤542.5的33.643倍(P<0.01)。ROC曲线分析SII可预测MHD患者抑郁状态的发生,AUC=0.768,诊断界值>774.53(P<0.001)。结论与非抑郁的MHD患者相比,抑郁患者体内炎症更强,免疫功能更差,高SII是MHD患者抑郁状态的独立危险因素,是预测识别MHD患者抑郁的新型炎症标志物。

Objective To explore the correlation between depression and systemic immune inflammation index(SII)in maintenance hemodialysis(MHD)patients.Methods MHD patients who underwent regular dialysis in the hemodialysis room of Beijing Integrated Traditional Chinese and Western Medicine Hospital from February 2023 to June 2023 were selected.Based on the Hospital Anxiety and Depression Scale(HADS)score,the patients were divided into a non depression group and a depression group.Independent risk factors for depression in MHD patients were analyzed through inter group comparison,univariate,and multivariate logistic regression analysis,and the predictive value of SII on depression symptoms in MHD patients was evaluated by subject work characteristic curve(ROC).Results Among 73 MHD patients included,32 were in a depressive state(43.84%).The comparison between groups showed that the body mass index(BMI),platelet count,albumin(P<0.01),and SII(P<0.001)in the depressive group were significantly higher than those in the non depressive group,while total cholesterol(TC),education years,and low density lipoprotein cholesterol(LDL-C)(P<0.05)were significantly lower than those in the non depressive group.Multivariate logistic regression showed that the quartile of SII was an independent risk factor for depression in MHD patients.Among them,MHD patients with SII between 692.82 and 1128.6 had a depression risk 8.346 times that of SII≤542.5(P<0.05),and MHD patients with SII>1128.6 had a depression risk 33.643 times that of SII≤542.5(P<0.01).ROC curve analysis of SII can predict the occurrence of depression in MHD patients,with AUC of 0.768 and diagnostic threshold of>774.53(P<0.001).Conclusion Compared with non depressive MHD patients,depressive patients have stronger inflammation and poorer immune function.High SII is an independent risk factor for depression in MHD patients and an ideal inflammatory marker for predicting and identifying depression in MHD patients.