系统性炎症反应指数在不稳定的胸痛和非ST升高心肌梗塞的差异化
Serdar Akyel1, Abdulkadir Yildiz
1Department of Cardiology, Kastamonu University School of Medicine, Kastamonu, Turkey.
Medicine
|December 16, 2025
概括
在急性胸痛患者中,系统性炎症反应指数 (SIRI) 可以帮助区分非ST升高心肌梗塞 (NSTEMI) 和不稳定的胸痛 (USAP). 在入院时较高的SIRI水平表明NSTEMI的可能性更高.
科学领域:
- 心脏病学 心脏病学
- 临床化学 临床化学
- 炎症生物标志物 炎症生物标志物
背景情况:
- 系统性炎症反应指数 (SIRI) 是由完整血清参数获得的炎症标志物.
- 区分非ST升高心肌梗塞 (NSTEMI) 和不稳定性胸痛 (USAP) 对于及时和适当的患者管理至关重要.
- 早期识别NSTEMI可以导致迅速的再输血治疗和改善患者的治疗结果.
研究的目的:
- 评估SIRI在区分NSTEMI和USAP的有用性,在出现急性胸痛的患者中.
- 评估SIRI是否可以作为心肌梗塞的早期预测因子,如果没有初始的平素升高.
主要方法:
- 一项回顾性观察性研究包括151名患有胸痛和最初负的高敏感性托罗邦素-I水平的患者.
- 患者被分为NSTEMI (随后的热激素升高) 或USAP (没有热激素升高) 组.
- 系统性炎症反应指数 (SIRI) 在入院时使用中性粒细胞,单细胞和淋巴细胞计数计算.
主要成果:
- 与USAP组相比,NSTEMI组的入院SIRI值显著更高 (P < .001).与USAP组相比,NSTEMI组的入院SIRI值显著更高 (P < .001).
- 更高的SIRI水平独立地预测了热素阳性 (OR,1.47;95% CI,1.17-1.84).
- 接收器操作特征分析显示,曲线下的面积为0.71,切线为1.58,产生72%的灵敏度和69%的特异性,用于预测热素阳性.
结论:
- 系统性炎症反应指数 (SIRI) 是一种有价值,易于获得和廉价的工具,用于早期区分NSTEMI与USAP.
- 简单的SIRI计算使其适用于各种医疗保健环境,有助于急性胸痛的快速临床决策.
- 使用SIRI可能会提高急性冠状动脉综合征患者的诊断准确度和管理.
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