中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (03): 197-201.doi: 10.3969/j.issn.1671-4091.2026.03.005

• 临床研究 • 上一篇    下一篇

新型炎症标志物对维持性血液透析患者心脑血管事件的预测价值

张 珊     张素馨    刁宗礼     陈雅丽      陈欣攀   

  1. 100050 北京，1首都医科大学附属北京友谊医院肾内科
  • 收稿日期:2025-08-15 修回日期:2025-12-10 出版日期:2026-03-12 发布日期:2026-03-12
  • 通讯作者: 张素馨 E-mail:zhangxw28@163.com

The predictive value of novel inflammatory markers for cardiovascular and cerebrovascular events in maintenance hemodialysis patients

ZHANG Shan, ZHANG Su-xin, DIAO Zong-li, CHEN Ya-li, CHEN Xin-pan   

  1. Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • Received:2025-08-15 Revised:2025-12-10 Online:2026-03-12 Published:2026-03-12
  • Contact: 100050 北京，1首都医科大学附属北京友谊医院肾内科 E-mail:zhangxw28@163.com

摘要： 目的 探讨新型炎症标志物对维持性血液透析患者心脑血管事件的预测价值。 方法 回顾性分析2019年1月1日—2024年1月1日于首都医科大学附属北京友谊医院行维持性血液透析(maintenance hemodialysis，MHD)的患者为研究对象。根据患者是否发生心脑血管事件分为心脑血管事件组和非心脑血管事件组。比较2组一般资料和实验室指标，采用Mann-Whitney检验及COX比例风险回归模型评估炎性指标与MHD患者发生心脑血管事件的关系。使用受试者工作特征(receiver operating characteristic，ROC)曲线评估基线血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)和全身免疫炎症指数(systemic imune-inflammation index,SII)对MHD患者发生心脑血管事件的预测价值。 结果 共纳入157例患者，其中发生心脑血管事件42例(26.75%)。心脑血管事件组年龄(U=1905.500，  P=0.043)、体质量指数(body mass index,BMI)(t=-7.965，P＜0.001)、血红蛋白(U=1744.000，P=0.008)、血小板计数(t=-9.416，P＜0.001)、中性粒细胞计数(U=443.500，P＜0.001)、超敏C反应蛋白(high sensitivity C-reactive protein，hs-CRP)(U=691.000，P＜0.001)、钙(U=1872.000，P=0.031)、SII     (U=343.000，P＜0.001)、PLR(U=721.500，P＜0.001)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)(U=679.000，P＜0.001)高于非心脑血管事件组，淋巴细胞计数(t=3.173，P=0.002)低于非心脑血管事件组；SII(HR=1.001，95%CI：1.001～1.002，P＜0.001)、PLR(HR=1.005，95%CI：1.001～1.009，P=0.009)是MHD患者发生心脑血管事件的独立危险因素；SII对MHD患者心脑血管事件的预测价值优于PLR，其1年、3年、5年的ROC曲线下面积(area under the curve,AUC)分别为 0.837、0.869、0.865，PLR对应时间点的AUC为0.725、0.752、0.784。 结论 SII及PLR水平均与MHD患者发生心脑血管事件相关，SII预测价值更优，可作为MHD患者发生心脑血管事件的早期评估参考指标。

关键词: 炎症标志物, 维持性血液透析, 心脑血管事件

Abstract: Objective  To explore the predictive value of novel inflammatory markers for cardiovascular and cerebrovascular events in maintenance hemodialysis  (MHD) patients. Methods  A retrospective analysis was performed on patients who received MHD in Beijing Friendship Hospital, Capital Medical University from January 1 2019 to January 1 2024. Patients were divided into a cardiovascular and cerebrovascular event group and a non-event group based on the occurrence of such events. General data and laboratory indicators were compared between the two groups. The Mann-Whitney U test and Cox proportional hazards regression model were used to assess the relationship between inflammatory indicators and the occurrence of cardiovascular and cerebrovascular events in MHD patients. The predictive value of baseline platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) for these events was evaluated using receiver operating characteristic (ROC) curve analysis.  Results  A total of 157 patients were enrolled, among whom 42 cases (26.75%) experienced cardiovascular and cerebrovascular events. The event group had higher age (U=1905.500, P=0.043), body mass index (BMI) (t=-7.965, P＜0.001), hemoglobin (U=1744.000, P=0.008), platelet count (t=-9.416, P＜0.001), neutrophil count (U=443.500, P＜0.001), high-sensitivity C-reactive protein (hs-CRP) (U=691.000, P＜0.001), calcium (U=1872.000, P=0.031), SII (U=343.000, P＜0.001), PLR (U=721.500, P＜0.001), and neutrophil-to-lymphocyte ratio (NLR) (U=679.000, P＜0.001), but lower lymphocyte count (t=3.173, P=0.002) compared to the non-event group. SII (HR=1.001, 95% CI: 1.001～1.002, P＜0.001) and PLR (HR=1.005, 95% CI: 1.001～1.009, P=0.009) were identified as independent risk factors for cardiovascular and cerebrovascular events in MHD patients. The predictive value of SII was superior to that of PLR, with area under the curve (AUC) values of 0.837, 0.869, and 0.865 at 1-year, 3-year, and 5-year time points, respectively. The corresponding AUC values for PLR were 0.725, 0.752, and 0.784.  Conclusion  Both SII and PLR levels are associated with cardiovascular and cerebrovascular events in MHD patients, and SII has a better predictive value, which can serve as a reference indicator for early evaluation of cardiovascular and cerebrovascular events in MHD patients.

Key words: Inflammatory markers, Maintenance hemodialysis, Cardiovascular and cerebrovascular events

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