Predictive Value of Systemic Immune-Inflammatory Index on Post-Stroke Depression in Patients with Acute Ischemic Stroke

doi:10.3969/j.issn.1673-5765.2024.02.010

Abstract

Abstract: Objective This study explored the correlation between systemic immune-inflammatory index (SII) and post-stroke depression (PSD) and the predictive value of SII for PSD diagnosis.
Methods Patients diagnosed with acute ischemic stroke for the first time in the Department of Neurology of Baoji Central Hospital from February 2019 to February 2021 were consecutively enrolled. The patients were divided into PSD group and non-PSD group according to the results of the HAMD-17, 30 days after onset. The two groups’ demographic characteristics, imaging data, baseline clinical data, and SII were compared, and multivariate logistic regression analysis was used to explore the correlation between SII and PSD.
Results A total of 307 patients were included in this study, including 103 patients in the PSD group and 204 patients in the non-PSD group. The SII in the PSD group was significantly higher than that in the non-PSD group[518.89×109/L (478.20×109/L-559.12×109/L) vs. 448.15×109/L
(407.88×109/L-490.16×109/L), P﹤0.001]. HAMD-17 score was positively correlated with SII in PSD patients (r=0.364, P﹤0.001). Multivariate logistic results indicated that increment of SII was an independent risk factor for PSD (middle tertile: OR 1.170, 95%CI 1.325-2.364, P=0.003; highest tertile: OR 2.472, 95%CI 1.747-3.469, P=0.001). ROC analysis showed that the AUC of PSD predicted by SII was 0.765 (95%CI 0.709-0.820, P﹤0.001) , the cut-off point for predicting PSD was 478.18×109/L, the sensitivity was 75.7%, and the specificity was 67.6%.
Conclusions Increased SII is an independent risk factor for PSD, which has a potential predictive value for diagnosing PSD.

Key words: Post-stroke depression; Systemic immune-inflammatory index; Risk factor

摘要： 目的探索系统性免疫炎症指数（systemic immune-inflammatory index，SII）与卒中后抑郁（post-stroke depression，PSD）的关系及SII对PSD的预测价值。
方法连续纳入2019年2月—2021年2月在宝鸡市中心医院神经内科住院治疗的缺血性卒中患者，进行回顾性分析。根据发病30 d后HAMD-17评分分为PSD组和非PSD组。比较两组患者人口学特点、影像资料、临床基线数据、SII等信息，采用多因素logistic回归分析法来研究SII与PSD的关系。
结果本研究共纳入307例患者，其中PSD组103例，非PSD组204例。PSD组患者的SII明显高于非PSD组[518.89×109/L（478.20×109/L～559.12×109/L）vs. 448.15×109/L（407.88×109/L～
490.16×109/L），P＜0.001]。PSD组患者HAMD-17评分与SII呈正相关（r=0.364，P＜0.001）。多因素logistic分析提示SII增高是PSD发病的独立性危险因素（中间三分位数：OR 1.770，95%CI 1.325～2.364，P=0.003；较高三分位数：OR 2.472，95%CI 1.747～3.469，P=0.001）。ROC分析显示，SII预测PSD对应的AUC为0.765（95%CI 0.709～0.820，P＜0.001），SII预测PSD的最佳临界值为478.18×109/L，此时敏感度为75.7%，特异度为67.6%。
结论 SII增高可能是PSD的独立性危险因素，对PSD有潜在的预测价值。

关键词: 卒中后抑郁; 系统性免疫炎症指数; 危险因素

CLC Number:

LUO Dong, LI Guoliang, WEN Huijun, WANG Junwen. Predictive Value of Systemic Immune-Inflammatory Index on Post-Stroke Depression in Patients with Acute Ischemic Stroke[J]. Chinese Journal of Stroke, 2024, 19(2): 190-196.

罗冬, 李国梁, 温慧军, 王军文. 系统性免疫炎症指数对急性缺血性卒中后抑郁的预测价值[J]. 中国卒中杂志, 2024, 19(2): 190-196.

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