系统免疫炎症指数与急性冠脉综合征患者PCI术后冠状动脉病变进展的相关性研究

Correlation Analysis of SII with Progression of Coronary Lesions in Patients with Acute Coronary Syndrome after PCI

摘要: 目的：探究系统免疫炎性指数(SII)与急性冠状动脉综合征经皮冠脉介入治疗(PCI)术后病变血管进展的相关性。方法：回顾性分析2019年1月至2022年6月于安徽医科大学第二附属医院初次行PCI治疗并在6~24个月内再次行冠脉造影术(CAG)复查的194例急性冠脉综合征患者，其中100例发生了病变血管进展(进展组)，94例未发生病变血管进展(非进展组)。通过入院后检测患者血小板、中性粒细胞及淋巴细胞水平，计算患者基线期及随访期SII水平，比较两组患者的临床资料；评估SII对患者预后的预测价值。结果：进展组吸烟患者的占比、CRP数值高于非进展组(P < 0.05)；非进展组SII、PLR、NLR及NHR均低于进展组(P < 0.05)；SII、PLR、NLR及NHR升高是急性冠状动脉综合征患者PCI术后病变血管进展的独立危险因素(P < 0.05)；SII预测急性冠状动脉综合征患者PCI术后病变血管进展的价值最高，约登指数最大时，曲线下面积(AUC)为0.745，对应临界值为8.570，特异度和敏感度分别为73.00%和78.30%。结论：SII、PLR、NLR及NHR对急性冠状动脉综合征PCI术后病变血管进展具有良好的预测价值，其中SII更具有诊断预测价值，为患者临床治疗提供一定指导作用。

Abstract: Objective: To explore the correlation between the Systemic Immune-Inflammation Index (SII) and the rapid progression of lesion vessels after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. Methods: A retrospective analysis was conducted on 194 patients with acute coronary syndrome who underwent their first PCI treatment at the Second Affiliated Hospital of Anhui Medical University from January 2019 to June 2022 and underwent CAG re-examination within 6 to 24 months. Among them, 100 cases experienced rapid progression of lesion vessels (progression group), and 94 cases showed no progression (non-progression group). By measuring the levels of platelets, neutrophils, and lymphocytes in patients after admission, the SII levels at baseline and follow-up periods were calculated, and the clinical data of the two groups of patients were compared; the predictive value of SII for patient prognosis was assessed. Results: The proportion of smokers and CRP values in the progression group were higher than those in the non-progression group (P < 0.05); the SII, PLR, NLR, and NHR in the non-progression group were all lower than those in the progression group (P < 0.05); increased SII, PLR, NLR, and NHR are independent risk factors for the rapid progression of lesion vessels after PCI in patients with acute coronary syndrome (P < 0.05); SII has the highest predictive value for the rapid progression of lesion vessels after PCI in patients with acute coronary syndrome, with the area under the curve (AUC) being 0.745 when the Youden index is the largest, corresponding to a critical value of 8.570, with specificity and sensitivity of 73.00% and 78.30%, respectively. Conclusion: SII, PLR, NLR, and NHR have good predictive value for the rapid progression of lesion vessels after PCI in patients with acute coronary syndrome, among which SII has a higher diagnostic predictive value and provides certain guidance for clinical treatment of patients.