系统性炎症反应指数和C反应蛋白-甘油三酯-葡萄糖指数与高血压肾损害的相关性研究OA

Objective To explore the correlations of systemic inflammation response index(SIRI)and C-reactive protein-triglyceride-glucose index(CTI)with hypertensive renal damage.Methods A retrospective case-control study design was adopted.A total of 462 patients with hyper-tension in the Jiangsu Provincial Hospital of Chinese Medicine from March 2022 to March 2024 were consecutively enrolled,and they were divided into renal damage group(n=110)and non-renal dam-age group(n=352)according to the diagnostic criteria for hypertensive renal damage.Clinical data were collected,and SIRI and CTI were calculated.Multivariate Logistic regression model was used to analyze the associations of SIRI and CTI with renal damage,and the receiver operating characteristic(ROC)curve was plotted to evaluate the discriminative value of SIRI and CTI.Results Statistically significant differences were found between the renal damage group and the non-renal damage group in terms of gender,use of antihypertensive drugs,urea,serum creatinine,estimated glomerular fil-tration rate(eGFR),serum uric acid,high-density lipoprotein cholesterol,C-reactive protein(CRP),white blood cell count,absolute neutrophil count,absolute monocyte count,urinary albu-min-to-creatinine ratio(uACR),SIRI and CTI levels(P＜0.05).Multivariate Logistic regression analysis showed that after adjusting for confounding factors,SIRI was a risk factor for hypertensive renal damage(OR=7.78,95％CI,4.43 to 13.67,P＜0.001),with a clear dose-response rela-tionship(P for trend＜0.001).CTI only showed a marginally significant association with hyperten-sive renal damage(OR=1.02,95％CI,1.00 to 1.04,P=0.060),no progressively increasing risk gradient was observed in the quartile stratification,and its independent risk value was limited.The risk stratification of the renal damage population based on KDIGO 2024 guidelines indicated that SIRI and CTI could distinguish populations with low risk from those with moderate risk and above of renal damage,but failed to distinguish populations with moderate risk from those with high risk or extremely high risk.ROC curve analysis showed that the area under the curve(AUC)of SIRI,CTI and the combined model for predicting renal damage was 0.757,0.582 and 0.792,respectively.The sensitivity of SIRI was 81.8％and the specificity was 60.2％.The sensitivity of CTI was 48.2％and the specificity was 68.2％.The sensitivity of the combined model was 77.3％and the specifici-ty was 71.3％.Conclusion SIRI is a strong independent factor for hypertensive renal damage,with a dose-response relationship.CTI has a weak association with hypertensive renal damage,and its predictive value alone is limited.The combined evaluation of renal damage risk with SIRI,CTI and traditional clinical indicators such as age,gender,blood lipid and uric acid can provide a basis for early clinical identification of high-risk populations with hypertensive renal damage.