Abstract:

Objective To investigate the predictive value of systemic immune-inflammation index（SII）for postoperative adverse outcomes in heart transplant recipients. Methods A retrospective analysis was conducted on the clinical data of 64 heart transplant recipients at Central China Fuwai Hospital of Zhengzhou University from April 1，2018，to December 10，2024. The patients were stratified into a favorable-prognosis group and an adverse-prognosis group based on the occurrence of postoperative adverse outcomes. Logistic regression analysis was used to identify risk factors for adverse outcomes，and the receiver operating characteristic（ROC）curve was employed to determine the area under the curve（AUC）of SII in predicting adverse outcomes. According to the optimal cutoff value，the64 patients were stratified into high-SII and low-SII groups，and their perioperative data were compared. Results SII and cardiopulmonary bypass time were identified as risk factors for postoperative adverse outcomes. The AUC of SII for predicting adverse outcomes was 0.793，with an optimal cutoff value of 765.5，yielding a sensitivityof 80.0% and a specificity of 74.1%. When the patients were divided into high- and low-SII groups based on the cutoff value，the high-SII group exhibited a significantly higher postoperative ECMO utilization rate（31 .8% vs.4.8%，P＝0.006）and incidence of adverse outcomes（36 .4% vs. 4.8%，P＝0.02）compared to the low-SII group. Additionally，the duration of postoperative mechanical ventilation（h）was longer in the high-SII group〔72 .5（48 .0，141.5）h vs. 42.0（23 .0，84.5）h，P＝0.02〕. Conclusion As a simple and readily available biomarker，SII has certain predictive value for adverse outcomes in heart transplant recipients. When SII exceeds 765.5，there may be an increased risk of adverse postoperative events.

Key words:

text-indent:0pt, vertical-align:middle, "> Heart transplantation； Systemic immune-inflammation index； Inflammatory state

摘要：

 目的 探究全身免疫炎症指数（systemic immune-inflammation index，SII）对心脏移植患者术后不良结局的预测价值。 方法 回顾性分析2018 年4 月1 日至2024 年12 月10 日在郑州大学华中阜外医院接受心脏移植的64 例受者的临床资料，根据术后是否发生不良结局分为预后良好组和预后不良组，使用Logistic 回归分析发生不良结局的危险因素，并通过受试者操作特征曲线（receiver operating characteristic curve，ROC）确定SII 预测不良结局的曲线下面积（area under curve，AUC），根据最佳截断值将64 例患者分为高SII 组及低SII 组，比较两组的围手术期资料。 结果 SII 及体外循环时间是发生术后不良结局的危险因素，SII 预测不良结局的AUC 为0.793，最佳截断值为765.5 时，SII 预测的灵敏度为80.0%，特异度为74.1%。以最佳截断值将64 例患者分为高低两组进行比较，结果发现高SII 组术后体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）使用率（31.8% 比4.8%，P＝0.006）及不良结局发生率（36.4% 比4.8%， P＝0.02）高于低SII 组，术后机械通气时间也长于低SII 组〔72 .5（48.0，141.5）h 比42.0（23.0，84.5）h， P＝0.02〕。 结论 SII 作为一种简单、易得的生物标志物，对心脏移植患者不良结局具有一定的预测价值，当SII＞765.5 时，术后发生不良结局的风险可能增加。

关键词:

text-indent:0pt, vertical-align:middle, "> 心脏移植； 全身免疫炎症指数； 炎症状态