The prognostic value of systemic immune-inflammation index in patients with IgA nephropathy
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摘要: 目的 探讨全身免疫炎症指数(SII)对IgA肾病患者预后的评估价值。方法 回顾性分析2017年1月—2021年12月在徐州医科大学附属医院首次行肾活检且病理诊断为原发性IgA肾病患者的基线实验室检查指标及病理检查结果。通过ROC 曲线计算SII最佳截断值,并以此将患者分为高SII组和低SII组,比较2组患者临床资料。采用 Kaplan-Meier 曲线和多变量Cox模型确定SII与IgA肾病患者预后的关系。结果 本研究共纳入 143 例 IgA肾病患者,随访时间为 31 (22,38) 个月。SII与IgA肾病患者的病理分级密切相关,女性IgA肾病患者的血清SII明显高于男性(P<0.05),Cox回归分析显示,节段性肾小球硬化、血小板与淋巴细胞比值(PLR)、24 h尿蛋白定量和SII是IgA肾病的独立危险因素。Kaplan-Meier曲线显示,高SII组比低SII组更有可能出现较差的肾脏结局(P<0.05)。结论 SII与原发性IgA肾病临床危险因素及病理分级密切相关,SII水平越高,患者预后越差。SII是IgA肾病患者不良预后的独立影响因子。Abstract: Objective To investigate the prognostic value of systemic immune-inflammation index (SII) in patients with IgA nephropathy.Methods Retrospective analysis was conducted on baseline laboratory and pathological examination results of patients who underwent their first renal biopsy and were pathologically diagnosed with primary IgA nephropathy at the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2021. The optimal cutoff value for SII was determined using the ROC curve. Accordingly, the patients were divided into two groups: a high SII group and a low SII group. Their clinical data were compared. Kaplan-Meier curves and multivariable Cox models were used to assess the relationship between SII and prognosis in patients with IgA nephropathy.Results A total of 143 patients with IgA nephropathy were included in this study, with a median follow-up time of 31 (22,38) months. SII was found to be closely associated with the pathological grades of IgA nephropathy, and serum SII levels were significantly higher in female patients than in male patients (P<0.05). Cox regression analysis showed that segmental glomerulosclerosis, platelet to lymphocyte ratio (PLR), 24 hour proteinuria content, and SII were independent risk factors for IgA nephropathy. Kaplan-Meier curves indicated that patients in the high SII group were more likely to experience poor renal outcomes compared with those in the low SII group (P<0.05).Conclusions SII is closely related to clinical risk factors and pathological grades in primary IgA nephropathy, with higher SII levels associated with worse patient prognosis. SII is an independent prognostic factor for poor prognosis in IgA nephropathy.
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Keywords:
- IgA nephropathy /
- systemic immune-inflammation index /
- prognosis /
- clinical progress /
- risk factors
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