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糖尿病心力衰竭患者的系统炎症反应指数和住院死亡率:来自MIMIC-IV的证据
Tengxu Zhang1, Chaoqun Xu1, Ying Xu1
1Division of Cardiology, Department of Medicine, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
BMC cardiovascular disorders
|September 27, 2025
概括
系统性炎症反应指数 (SIRI) 预测了患有糖尿病 (DM) 和心力衰竭 (HF) 的重症患者的死亡率. 较高的SIRI水平与增加的住院死亡相关,有助于临床风险评估.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
背景情况:
- 系统性炎症是糖尿病 (DM) 和心力衰竭 (HF) 发病的关键.
- 系统性炎症反应指数 (SIRI) 在心血管疾病中具有预后价值.
- 在患有并发性DM和HF的患者中,SIRI的预后作用尚未得到充分确立.
研究的目的:
- 调查SIRI与DM和HF重病患者的住院死亡率之间的关联.
- 评估SIRI作为这种特定患者群体中死亡率的预测指标.
主要方法:
- 从MIMIC-IV数据库中分析了4410名患有DM和HF的危急病患者的临床数据.
- 根据SIRI四分位数,患者被分为四组.
- 用于评估SIRI与死亡率的关联的Kaplan-Meier生存分析,受限立方线和多变量Cox模型.
主要成果:
- 升高的SIRI与临床不稳定性相关 (心脏/呼吸率升高,血压降低) 和增加住院死亡率.
- 卡普兰-梅尔分析显示,SIRI水平较高的生存率较差.
- 最高的SIRI四分位数独立预测增加了住院,30天和90天的死亡率 (p < 0.001).
结论:
- 在DM和HF的重症患者中,SIRI独立预测了医院内死亡率.
- SIRI集成了中性粒细胞,淋巴细胞和单细胞计数,以提供全面的炎症概况.
- 这一发现支持SIRI在这些患者的风险分层和临床决策方面的实用性.
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