急性冠状动脉综合征的风险分层:系统性免疫炎症指数作为预后标志物
Elena Emilia Babes1,2, Andrei-Flavius Radu1,3, Noemi Adaus Cretu1
1Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania.
Medical sciences (Basel, Switzerland)
|August 22, 2025
概括
系统性免疫炎症指数 (SII) 有效预测急性冠状动脉综合征 (ACS) 患者的短期死亡率和主要心血管和脑部不良事件 (MACCE). 升高的SII表明风险更高,特别是在ST段升高心肌梗塞 (STEMI) 中.
科学领域:
- 心血管医学
- 临床免疫学
- 生物标志物研究
背景情况:
- 炎症是急性冠状动脉综合征 (ACS) 的关键因素.
- 系统性免疫炎症指数 (SII) 整合了免疫和炎症标志物.
- 在ACS中SII的预后值需要进一步评估.
研究的目的:
- 评估SII作为ACS患者短期死亡率预测的有用性.
- 评估SII在30天内预测重大心血管和大脑不良事件 (MACCE) 的作用.
- 将SII的预测性能与特定ACS子类型的已知标记进行比较.
主要方法:
- 在2023年入院的964名ACS患者的回顾性分析.
- 使用血液学参数计算SII.
- 主要终点:30天死亡率;次要终点:MACCE.
主要成果:
- 在ACS亚型中,SII水平显著不同,在ST段升高心肌梗塞 (STEMI) 中最高.
- 较高的SII与较高的30天死亡率 (OR=1. 038) 和MACCE (OR=1. 080) 独立相关.
- 在MACCE (AUC=0. 762) 中,SII的预测准确度中等,在STEMI (AUC=0. 874) 中,其准确度优于其他标志物.
结论:
- 系统性免疫炎症指数 (SII) 是一个具有成本效益的生物标志物,反映了ACS中的炎症,免疫力和血栓形成.
- 在ACS患者中,SII升高是短期死亡率和MACCE的重要预测因素.
- 将SII与GRACE 2评分相结合,可以提高预后能力,特别是在特异性方面.
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