中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (01): 36-39,63.doi: 10.3969/j.issn.1671-4091.2026.01.008

• 临床研究 • 上一篇    下一篇

全身免疫炎症指数对首发腹膜透析相关性腹膜炎的早期预测价值

樊璐璐   罗阳燕   向洪玉   高 芳   

  1. 610500 成都，1成都医学院第一附属医院肾病科
  • 收稿日期:2025-06-16 修回日期:2025-10-17 出版日期:2026-01-12 发布日期:2025-12-31
  • 通讯作者: 高芳 E-mail:158468931@qq.com
  • 基金资助:
    成都市金牛区医学会肾脏专项课题重点项目(JNQN20-24)

Early predictive value of the systemic immune-inflammation index for first episode peritoneal dialysis-associated peritonitis

FAN Lu-lu, LUO Yang-yan, XIANG Hong-yu, GAO Fang   

  1. Department of Nephrology, the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
  • Received:2025-06-16 Revised:2025-10-17 Online:2026-01-12 Published:2025-12-31
  • Contact: 610500 成都，1成都医学院第一附属医院肾病科 E-mail:158468931@qq.com

摘要： 目的  探讨全身免疫炎症指数(systemic immune-inflammation index,SII)对腹膜透析(peritoneal dialysis,PD)患者首发腹膜透析相关性腹膜炎(peritoneal dialysis-associated peritonitis,PDAP)的早期预测价值。 方法  选取2010年11月—2023年11月于成都医学院第一附属医院肾病科就诊的PD患者。根据有无首次PDAP分为腹膜炎组和非腹膜炎组。采用相关性分析和Logistic回归法研究SII与首发PDAP的关系，绘制受试者工作特征曲线分析SII对首发PDAP的预测价值。 结果  共纳入302例患者，其中腹膜炎组137例，非腹膜炎组165例。与非腹膜炎组相比，腹膜炎组透析龄、SII值、中性粒细胞计数、单核细胞计数及低密度脂蛋白胆固醇水平更高(Z=-4.641、       -5.221、-7.446、-2.114、-2.305,P＜0.001、＜0.001、＜0.001、0.034、0.021)。相关分析显示SII水平与首发PDAP呈正相关(r=0.231,P＜0.001)。多因素Logistic回归分析显示高SII(OR=1.001，95%CI：1.000～1.001，P＜0.001)及长透析龄(OR=1.020，95% CI：1.011～1.029，P＜0.001)是首发PDAP的独立危险因素。受试者工作特征曲线显示SII预测首发PDAP的曲线下面积为0.674(95%CI：0.615～0.734)，最佳截断值为780.51，敏感度为70.8%，特异度为58.2%。 结论  高SII、长透析龄是首发PDAP的独立影响因素，SII可作为早期预测首发PDAP的标志物。

关键词: 全身免疫炎症指数, 腹膜透析, 腹膜透析相关性腹膜炎, 预测价值

Abstract: Objective  To investigate the early predictive value of the systemic immune-inflammation index (SII) for the first episode of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD). Methods  PD patients treated in the Department of Nephrology at the First Affiliated Hospital of Chengdu Medical College from November 2010 to November 2023 were selected. Based on the occurrence of the first PDAP, patients were divided into a peritonitis group and a non-peritonitis group. Correlation analysis and Logistic regression were used to study the relationship between SII and the first PDAP, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of SII for the first PDAP. Results A total of 302 patients were included, with 137 in the peritonitis group and 165 in the non-peritonitis group. Compared to the non-peritonitis group, the peritonitis group had longer dialysis vintage, higher SII values, neutrophil counts, monocyte counts, and higher low-density lipoprotein cholesterol levels (Z=-4.641, -5.221, -7.446, -2.114, -2.305; P ＜0.001, ＜0.001, ＜0.001, 0.034, 0.021). Correlation analysis showed a positive correlation between SII levels and the first PDAP (r = 0.231, P＜0.001). Multivariate Logistic regression analysis indicated that a high SII (OR = 1.001, 95% CI: 1.000～1.001, P＜0.001) and longer dialysis vintage (OR = 1.020, 95% CI: 1.011～1.029, P ＜0.001) were independent risk factors for the first PDAP. The ROC curve showed that the area under the curve (AUC) for SII in predicting the first PDAP was 0.674 (95% CI: 0.615～0.734), with an optimal cut-off value of 780.51, sensitivity of 70.8%, and specificity of 58.2%.  Conclusion  Elevated SII and  longer dialysis  vintage are independent risk factors for first episode PDAP, and SII can serve as an early predictive marker.

Key words: Systemic immune-inflammation index, Peritoneal dialysis, Peritoneal dialysis-associated peritonitis, Predictive value

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