系统性免疫炎症指数与IgA肾病患者临床病理特征的关系

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中图分类号：R692.3 文献标志码：A DOI：10.11958/20251184

Abstract：ObjectiveTo explore the correlation between the systemic immune-inflammation index （SII）and the clinicaland pathological characteristicsof patients with IgAnephropathy（IgAN）.MethodsAtotal of35O patients who underwentrenal biopsyandwere initiallydiagnosed withprimary IgANwereselected.Theclinicalandpathologicaldataof thepatientswerecoected，andSIwascalculated.AcordingtotemedanSIlevelof554.78inperipheralblood，teIgAN patients were divided into the low SII group （SII ⩽554.78 ，175 cases） and the high SII group （SII >554.78 ，175 cases）. Based on the presenceorabsenceof endocapilary hyperplastic（E）lesion，35O patients were alsodivided intotheEO group （279 cases， 79.7% ） and the E1 group （71 cases， 20.3% ）. Multivariate Logistic regression analysis was conducted to determine the influencing factors ofE1in IgANpatients.A predictivemodel was established，andthe predictivevalueofthe model was evaluatedusing thereceiver operating characteristic （ROC）curve.ResultsThere were higher systolicblood pressure （SBP），plateletcount （PLT），neutrophilcount （NEU），neutrophil-to-lymphocyteratio （NLR），platelet-to-lymphocyteratio （PLR），total cholesterol （TC），serumcreatinine （Scr），serum C3and24-hour urine proteinlevels inthehigh SIgroupthan those of the low SII group，while the lymphocyte count （LYM） waslower（ P<0.05 ）.In terms of pathological manifestations， the proportion of E1 was higher in the high SII group than that of thelow SII group （ P<0.05 ）.Therewere lower PLT，NEU， NLR，PLR，Scrand24-hoururine protein in patientsofthe EOgroupthan thoseoftheE1 group，while higherHb，LYMand ALB levels in the EO group than those of the E1 group Pℓ<0.05 ）.Multivariate Logisticregression analysis showed that elevatedSII，Scrand24-hoururineproteinlevels wereindependent risk factorsforE1lesioninIgANpatients（ P<0.05 ）

The area under the curve （AUC）of the predictive model for E1 lesion in IgAN patients was 0.781（95%CI： 0.722-0.840）. ConclusionSIIcanreflecttheclinicalandpathological severityin IgANpatients，providingnew isights forclinical evaluation of the disease progression in IgAN patients.

KeyWords：glomerulonephritis，IgA;proteinuria;systemic immune inflammationindex;endocapillary hypercellularity

IgA肾病（IgAN）是目前全世界范围内发病率较高的原发性肾小球疾病1]。（剩余11469字）