AISI与重症社区获得性肺炎患者预后的关联-现代医学

AISI与重症社区获得性肺炎患者预后的关联

单位：1. 川北医学院临床医学院, 四川南充 637000;
2. 川北医学院附属医院呼吸与危重症医学科, 四川南充 637000

分类号：R563.1

出版年·卷·期（页码）：2026·54·第五期（824-831）

摘要：

目的：探讨全身炎症综合指数(AISI)与重症社区获得性肺炎(SCAP)患者预后的关联。方法：采用单中心回顾性队列研究，纳入2020年4月至2025年6月收治的224例SCAP患者。收集入院后24 h内的临床资料，由于AISI呈偏态分布，采用以10为底数的对数转换lgAISI进行后续分析。主要结局为入院后30 d和90 d全因死亡。采用X-tile软件进行风险分组，限制性立方样条(RCS)、Cox比例风险回归模型、Kaplan-Meier生存及亚组分析评估AISI与预后的关联。结果：224例患者中，30 d和90 d死亡率分别为34.4%和38.8%。多因素Cox回归分析显示，lgAISI与SCAP患者30 d死亡风险(HR=1.998,95%CI 1.278~3.125，P=0.002)和90 d死亡风险(HR=2.045，95%CI 1.348~3.104，P<0.001)呈正相关。亚组分析进一步揭示，在年龄＜65岁的人群中lgAISI与SCAP患者30 d和90 d死亡的更显著(P＜0.05)，在其余亚组间该关联性差异无统计学意义(P>0.05)。此外，lgAISI与ICU入住风险(OR=2.121,95%CI 1.230~3.658，P=0.007)呈显著正相关。结论：AISI与SCAP短期及中长期死亡风险之间存在正相关关系。AISI可能作为识别SCAP死亡高危人群的潜在指标。

Objective: To explore the correlation between the aggregate index of systemic inflammation(AISI) and the prognosis of patients with severe community-acquired pneumonia(SCAP). Methods:A single-center retrospective cohort study was conducted. A total of 224 patients diagnosed with SCAP admitted from April 2020 to June 2025 were enrolled. Baseline clinical data upon admission were collected. Given the skewed distribution of AISI, log-transformation with base 10(lgAISI) was applied for subsequent analyses. The primary endpoints were 30-day and 90-day all-cause mortality after admission. The X-tile software was used for risk stratification. Restricted cubic spline(RCS), Cox proportional hazards regression model, Kaplan-Meier survival analysis and subgroup analysis were adopted to evaluate the association between lgAISI and patient prognosis.Results: Among the 224 enrolled patients, the 30-day and 90-day mortality rates were 34.4% and 38.8%, respectively. Multivariate Cox regression analysis demonstrated that lgAISI was significantly positively correlated with 30-day mortality risk(HR=1.998, 95%CI 1.278-3.125, P=0.002) and 90-day mortality risk(HR=2.045, 95%CI 1.348-3.104, P<0.001) in SCAP patients. Subgroup analysis further indicated that the positive correlations of lgAISI with 30-day and 90-day mortality were more prominent in patients aged<65 years(P<0.05), while no significant inter-subgroup difference was observed in other subgroups(P>0.05). In addition, lgAISI was independently associated with an increased risk of ICU admission(OR=2.121, 95%CI 1.230-3.658, P=0.007). Conclusion: AISI is significantly positively correlated with short-term and medium-to-long-term mortality risks in SCAP patients. AISI may serve as a promising biomarker for identifying high-risk populations of mortality in SCAP.

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