目的 探讨全身炎症反应指数(systemic inflammatory response index,SIRI)与血液透析(hemodialysis,HD)患者心血管事件的相关性。 方法 收集并分析2019年1月—2021年1月在东莞东华医院规律血液透析≥3个月患者的基本信息、血常规及各项临床检验指标。 结果 心血管事件组SIRI水平高于无心血管事件组(Z=-3.558，P＜0.001)，心血管事件组患者年龄更大(χ2=-3.901，P＜0.001)，且白细胞计数(t=-3.104，P =0.002)、红细胞分布宽度(t=-2.746，P =0.006)、中性粒细胞计数(t=-3.117， P =0.002)、单核细胞计数(t=-2.492，P =0.013)、三酰甘油(Z=-2.508，P =0.012)、C-反应蛋白(CRP)(Z=-2.035，P =0.042)、单核细胞与淋巴细胞比值(monocyte-to-lymphocyte ratio,MLR)(Z=-2.552，P =0.011)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)(Z=-2.277，P=0.023)更高。COX风险比例模型分析显示高SIRI水平是HD患者心血管事件的独立危险因素(HR=2.307，95% CI：1.236～4.305，P=0.009)。ROC曲线分析显示SIRI、MLR、NLR的曲线下面积(AUC)分别为0.676、0.626、0.612，Youden指数分别为0.326、0.202、0.178，最佳截断值分别为1.15、0.35、4.98，灵敏度分别为87.23%、70.21%、40.43%，特异度分别为45.31%，50.00%，77.34%。 结论 SIRI是HD患者心血管事件的独立危险因素。
Objective To investigate the correlation between the systemic inflammatory response index (SIRI) and cardiovascular events in patients on hemodialysis (HD). Methods The basic clinical information, blood routine and laboratory examination results were collected and analyzed in patients treated with regularly HD for more than 3 months in Dongguan Tungwah Hospital in the period of January 2019 to January 2021. Results The SIRI level was significantly higher in the cardiovascular event group than in the non-cardiovascular event group (Z=-3.558, P＜0.001). Patients in the cardiovascular event group had a higher proportion of previous cardiovascular disease, older age (χ2=-3.901, P＜0.001), and higher levels of white blood cell count (t=-3.104, P=0.002), red blood cell distribution width (t=-2.746, P=0.006), neutrophil count (t=-3.117, P=0.002), monocyte count (t=-2.492, P=0.013), triglycerides (Z=-2.508, P=0.012), C-reactive protein (Z=-2.035, P=0.042), monocyte-to-lymphocyte ratio (MLR) (Z=-2.552, P=0.011), and neutrophil-to-lymphocyte ratio (NLR) (Z= -2.277, P=0.023). COX risk proportional model analysis showed that higher SIRI level was an independent risk factor for cardiovascular events in HD patients (HR=2.307, 95% CI:1.236～4.305, P=0.009). ROC analysis showed that the area under the curve (AUC) of SIRI, MLR, and NLR were 0.676, 0.626, and 0.612, respectively, and the Youden indices were 0.326, 0.202, and 0.178, respectively, with the optimal cut-off values of 1.15, 0.35, and 4.98 respectively, sensitivity of 87.23%, 70.21%, and 40.43% respectively, and specificity of 45.31%, 50.00%, and 77.34%, respectively. Conclusion SIRI is an independent risk factor for cardiovascular events in HD patients.
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