系统免疫炎症指数与2型糖尿病微血管并发症的研究进展

Research Progress on Systemic Immune-Inflammation Index and Microvascular Complications in Type 2 Diabetes Mellitus

摘要: 糖尿病及其微血管并发症是全球性的健康挑战。系统免疫炎症指数(SII)作为一种新兴的、基于血常规的复合炎症指标，因其经济、简便的特性，在评估糖尿病慢性炎症及相关并发症风险中的作用日益受到关注。本文综述了SII的计算方法及其反映中性粒细胞、血小板、淋巴细胞平衡的病理生理学基础，并系统梳理了SII与糖尿病视网膜病变、糖尿病周围神经病变、糖尿病肾病三大微血管并发症的临床研究证据。现有研究表明，SII与上述并发症的存在、严重程度及不良预后存在显著关联，并展现出一定的预测价值。然而，现有证据多基于横断面研究，其标准化的临床应用方案尚未确立。未来需通过前瞻性研究确立其针对不同场景的截断值并验证其预测模型价值，以推动SII成为辅助早期识别与风险分层管理的实用工具。

Abstract: Diabetes mellitus and its microvascular complications pose a significant global health challenge. The Systemic Immune-Inflammation Index (SII), an emerging composite inflammatory marker derived from routine blood counts, has gained increasing attention for assessing chronic inflammation and associated complication risks in diabetes, owing to its cost-effectiveness and accessibility. This review outlines the calculation of SII and its pathophysiological basis in reflecting the balance among neutrophils, platelets, and lymphocytes. It systematically summarizes clinical evidence on the associations between SII and the three major microvascular complications: diabetic retinopathy, diabetic peripheral neuropathy, and diabetic kidney disease. Current studies indicate that SII is significantly correlated with the presence, severity, and adverse prognosis of these complications, demonstrating considerable predictive potential. However, most existing evidence is derived from cross-sectional studies, and a standardized clinical application protocol for SII has yet to be established. Future prospective studies are warranted to define context-specific cut-off values and validate its utility in integrated predictive models, thereby facilitating the use of SII as a practical tool for early identification and risk-stratified management of diabetic microvascular complications.