METHODS: This retrospective study involved 981 patients with biopsy-confirmed IgAN from West China Hospital of Sichuan University between 2008 and 2019. The patients were divided into two groups based on the SIRI\'s optimal cut-off value calculated by the X-tile: the low SIRI group (SIRI ≤ 0.63, n = 312) and the high SIRI group (SIRI > 0.63, n = 669). Basic clinical characteristics at the time of renal biopsy were evaluated, and the relationship between SIRI and the combined endpoint was analyzed. We also used the Cox proportional hazard model and Kaplan‒Meier curve to evaluate the renal prognosis of IgAN.
RESULTS: A total of 981 IgAN patients were included. During a median follow-up period of 56.7 months (36.8-80.4 months), 122 patients progressed to the combined endpoint (12.4%). Patients were divided into a low SIRI group (SIRI ≤ 0.63, n = 312) and a high SIRI group (SIRI > 0.63, n = 669) according to the optimal cut-off value of the systemic inflammatory response index (SIRI). Further analysis showed that a higher SIRI value was significantly associated with the risk of IgAN patients reaching the composite endpoint (HR 1.62, 95% CI 1.02-2.56, p = 0.041).
CONCLUSIONS: High SIRI is a significant and independent risk factor for renal disease progression in IgAN patients.
方法:本回顾性研究纳入四川大学华西医院2008-2019年经活检确诊为IgAN的981例患者。根据X-tile计算的SIRI最佳临界值将患者分为两组:低SIRI组(SIRI≤0.63,n=312)和高SIRI组(SIRI>0.63,n=669)。评估肾活检时的基本临床特征,分析SIRI与合并终点的关系。我们还使用Cox比例风险模型和Kaplan-Meier曲线评估IgAN的肾脏预后。
结果:共纳入981例IgAN患者。在56.7个月(36.8-80.4个月)的中位随访期内,122例患者进展到联合终点(12.4%)。根据全身炎症反应指数(SIRI)的最佳临界值,将患者分为低SIRI组(SIRI≤0.63,n=312)和高SIRI组(SIRI>0.63,n=669)。进一步的分析表明,较高的SIRI值与IgAN患者达到复合终点的风险显着相关(HR1.62,95%CI1.02-2.56,p=0.041)。
结论:高SIRI是IgAN患者肾脏疾病进展的重要且独立的危险因素。