系统免疫炎症指数在急性胰腺炎中的研究进展

Research Progress of Systemic Immune-Inflammation Index in Acute Pancreatitis

摘要: 急性胰腺炎(AP)是临床常见的急腹症，病情呈动态演变性，部分重症患者可合并多器官损伤、感染性坏死等严重并发症，病死率较高。早期准确评估AP患者病情严重程度及预后，对于优化治疗策略、改善转归具有重要意义。系统免疫炎症指数(SII)是基于外周血中性粒细胞、淋巴细胞及血小板计数构建的新型复合炎症指标，因其计算简便、成本低廉且易获取，现已广泛应用于AP病情评估的相关研究。本文系统梳理了SII的概念、作用机制及其在AP病情严重程度分级、并发症风险预判及短期不良预后评估中的临床应用价值，探讨了SII在急诊分诊和病房监护中的潜在应用路径，深入分析了病因、年龄及基础疾病等混杂因素对SII的影响，并提出了相应的校正策略。未来仍需开展大样本、多中心的前瞻性临床研究，统一规范SII的检测时机、评判标准与适用人群，优化SII联合多指标的预测评估模型，为推动SII成为AP临床规范化辅助评估工具提供循证依据。

Abstract: Acute pancreatitis (AP) is a common acute abdominal disease in clinical practice, with a dynamically evolving condition. Some severe patients may have serious complications such as multiple organ damage and infectious necrosis, with a high mortality rate. Early and accurate assessment of the severity and prognosis of AP patients is of great significance for optimizing treatment strategies and improving outcomes. The Systemic Immune Inflammatory Index (SII) is a novel composite inflammatory index constructed based on peripheral blood neutrophil, lymphocyte, and platelet counts. Due to its simple calculation, low cost, and easy accessibility, it has been widely used in research related to the assessment of acute pancreatitis. This article systematically reviews the concept, mechanism of action, and clinical application value of SII in grading the severity of acute pancreatitis, predicting the risk of complications, and evaluating short-term poor prognosis. It explores the potential application pathways of SII in emergency triage and ward monitoring, analyzes in depth the impact of confounding factors such as etiology, age, and underlying diseases on SII, and proposes corresponding correction strategies. In the future, large-scale, multicenter prospective clinical studies are still needed to standardize the testing timing, evaluation criteria, and applicable population of SII, optimize the predictive evaluation model of SII combined with multiple indicators, and provide evidence-based support for promoting SII as a standardized auxiliary evaluation tool for AP clinical practice.