SII/SIRI在肝硬化食管胃底静脉曲张出血预测中的研究进展

Research Progress of SII/SIRI in Predicting Esophageal and Gastric Variceal Bleeding in Liver Cirrhosis

摘要: 肝硬化是各种慢性肝病进展的终末阶段，食管胃底静脉曲张出血(Esophageal and Gastric Variceal Bleeding, EVB)是其最严重的并发症之一，具有起病急、进展快、病死率高的特点，年发生率为5%~15%，6周病死率可达20%，未接受预防治疗的患者后期再出血率约为60%，且大部分发生在首次出血后1~2年。早期精准预测EVB的发生风险，对优化临床干预策略、降低出血发生率及病死率具有重要意义。系统免疫炎症指数(Systemic Immune-Inflammation Index, SII)和全身炎症反应指数(Systemic Inflammatory Response Index, SIRI)均是基于外周血常规指标构建的新型炎症免疫相关评分，具有检测便捷、成本低廉、可重复性强等优势，近年来被广泛应用于多种疾病的预后评估。本文结合近年来国内外相关研究，对SII、SIRI的检测原理及其在肝硬化EVB预测中的研究进展进行综述，分析两者的预测价值、现存问题及应用前景，为临床EVB的早期预警和个体化管理提供参考。

Abstract: Cirrhosis is the terminal stage of various chronic liver diseases, and esophageal and gastric variceal bleeding (EVB) is one of its most serious complications, characterized by sudden onset, rapid progression, and high mortality. The annual incidence is 5%~15%, the 6-week mortality rate can reach 20%, and in patients who do not receive preventive treatment, the rate of rebleeding later is about 60%, with most cases occurring 1~2 years after the first bleeding episode. Early and accurate prediction of the risk of EVB is of great significance for optimizing clinical intervention strategies and reducing the incidence of bleeding and mortality. The Systemic Immune-Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI) are both new inflammation-immune related scores constructed based on peripheral blood routine indicators, with advantages such as convenient testing, low cost, and strong reproducibility. In recent years, they have been widely used in the prognostic assessment of various diseases. This article, combining recent domestic and international studies, reviews the detection principles of SII and SIRI and their research progress in predicting EVB in cirrhosis, analyzing their predictive value, existing problems, and application prospects to provide a reference for early warning and individualized management of clinical EVB.