全身免疫炎症指数与急性心肌梗死患者再灌注后发生室性心律失常的关联性分析
Association between systemic immune inflammation index and ventricular arrhythmia after reperfusion in patients with acute myocardial infarction
艾丽菲热·艾海提 1马艺萍 1刘柯 2麦迪乃姆·阿卜力孜 1卡迪尔亚·依布拉音 1穆叶赛·尼加提3
作者信息
- 1. 830000 新疆维吾尔自治区乌鲁木齐市,新疆医科大学研究生院
- 2. 石河子大学医学院
- 3. 新疆维吾尔自治区人民医院急救中心
- 折叠
摘要
目的 评估全身免疫炎症指数(systemic immune-inflammation index,SII)与急性心肌梗死(acute myocardial infarction,AMI)患者再灌注治疗后室性心律失常(VA)发生风险间的关联性.方法 连续选取2023年1月至2024年4月就诊于新疆维吾尔自治区人民医院确诊为AMI并接受经皮冠状动脉介入术(PCI)的患者共计815例.根据SII中位数水平将患者分为低SII组(n=349)和高SII组(n=350)两组;结局指标为术后发生VA.采用logistic回归分析评估SII与AMI患者术后VA的关联,应用限制性立方样条图(RCS)评估二者间的剂量-反应关系,ROC曲线分析SII对术后VA发生事件的预测能力,同时进行亚组分析检验结果的稳健性.结果 在最终纳入的699例患者中,193例(27.6％)患者出现VA.校正潜在混杂因素后,SII每增加一个标准差,AMI患者的VA发生风险增加0.72倍(OR=1.72,95％CI 1.32～2.24,P＜0.001);与低SII组相比,高SII组AMI患者的VA发生风险增加1.42倍(OR=2.42,95％CI 1.44～4.07,P=0.001).多变量校正限制性立方样条图(RCS)显示,SII与AMI患者再灌注后发生风险之间存在线性剂量-反应关系(非线性P值=0.056).ROC 曲线分析,SII 预测 AMI 患者 PCI 后 VA 的曲线下面积(AUC)为 0.749(95％CI 0.704～0.795),敏感度70.9％,特异度71.5％.亚组分析提示,与＜60岁、女性患者相比,高SII水平与≥60岁的男性AMI患者PCI术后VA发生风险的关联更强.结论 SII升高与AMI患者再灌注后室性心律失常发生风险增加存在明显相关性,且随着SII水平升高,VA发生风险逐步增加.
Abstract
Objective To evaluate the association between systemic immune inflammation index(SII)and the risk of ventricular arrhythmia(VA)after reperfusion therapy in patients with acute myocardial infarction(AMI).Methods A total of 815 patients who were diagnosed with AMI and underwent percutaneous coronary intervention(PCI)in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2023 to April 2024 were selected.According to the median SII level,the patients were divided into two groups:the low-SII group(n=349)and the high-SII group(n=350).The outcome was the occurrence of postoperative VA.Logistic regression analysis was used to evaluate the association between SII and postoperative VA in patients with AMI,and the restricted cubic spline(RCS)was used to evaluate the dose-response relationship between the two variables.ROC curve was used to analyze the predictive ability of SII for postoperative VA events,and subgroup analysis was performed to test the robustness of the results.Results Of the 699 enrolled patients last,193(27.6％)had ventricular arrhythmias.After adjusting for the potential confounders,the risk of ventricular arrhythmia in patients with AMI increased by 0.72 times(OR=1.72,95％CI 1.32-2.24,P＜0.001)for each standard deviation increase in SII.Compared with the low SII group,the risk of VA in AMI patients in the high SII group increased by 1.42 times(OR=2.42,95％CI 1.44-4.07,P=0.001).RCS showed that there was a linear dose-response relationship between SII and the risk after reperfusion in AMI patients(P nonlinear=0.056).ROC curve analysis showed that the area under the curve(AUC)of SII for predicting ventricular arrhythmia after PCI in AMI patients was 0.749(95％CI 0.704-0.795),the sensitivity was 70.9％,and the specificity was 71.5％.Subgroup analysis suggested that high SII level was more strongly associated with the risk of ventricular arrhythmia after PCI in male AMI patients aged?60 years compared with patients aged＜60 years and female patients.Conclusion Increasing SII is significantly associated with increasing risk of VA after reperfusion in AMI patients,and the risk of VA increases progressively with the increase of SII level.
关键词
全身免疫炎症指数/急性心肌梗死/再灌注/室性心律失常/关联性Key words
Systemic immune inflammation index/Acute myocardial infarction/Reperfusion/Ventricular arrhythmia/Relevance引用本文复制引用
出版年
2024
NETL
NSTL
万方数据