NLR、SII、SIRI、AISI在老年慢性肾脏病合并颈动脉粥样硬化患者的病情程度和中医证型诊断中的意义OA

Objective To explore the significance of neutrophil-to-lymphocyte ratio(NLR),systemic immune-inflammation index(SII),systemic inflammatory response index(SIRI)and aggregate index of systemic inflammation(AISI)in assessing disease severity and diagnosing traditional Chinese medicine(TCM)syndromepattenrs in elderly patients with chronic kidney disease(CKD)complicated with carotid atherosclerosis(CAS).Methods Two hundred and two elderly patients with CKD complicated with CAS(including 82 cases of CKD stage 3 and 120 cases of CKD stage 4)who were treated in the outpatient and inpatient departments of Ganzhou Nankang Hospital of Traditional Chinese Medicine from January 2023 to September 2024 were selected as the case group,and 20 healthy examinees during the same period were selected as the control group.The differences in NLR,SII,SIRI and AISI between elderly CKD patients with CAS and healthy examinees were observed,as well as the relationship between different TCM syndrome pattern(including deficiency-root syndrome and excess-branch syndrome)and NLR,SII,SIRI,AISI in elderly CKD patients with CAS.Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the efficacy of NLR,SII,SIRI and AISI in evaluating the disease severity of elderly CKD complicated with CAS.Results(1)The levels of NLR,SII,SIRI and AISI in the case group were significantly higher than those in the healthy control group,with statistically significant differences(P＜0.001).(2)Among the 202 elderly patients with CKD complicated with CAS,the proportion of deficiency-root syndromes from high to low was:spleen-kidney yang deficiency syndrome(40.10%)＞qi-yin deficiency syndrome(23.76%)＞spleen-kidney qi deficiency syndrome(18.81%)＞yin-yang deficiency syndrome(17.33%).The proportion of excess-branch syndromes in descending order was:blood stasis syndrome(39.60%)＞turbidity-toxin syndrome(24.75%)＞damp-heat syndrome(20.80%)＞water-dampness syndrome(14.85%).(3)The levels of NLR,SII,SIRI and AISI in deficiency-root syndromes in descending order were:yin-yang deficiency syndrome＞spleen-kidney yang deficiency syndrome＞qi-yin deficiency syndrome＞spleen-kidney qi deficiency syndrome.In excess-branch syndromes,the order in descending order was:damp-heat syndrome＞turbidity-toxin syndrome＞blood stasis syndrome＞water-dampness syndrome,with statistically significant differences(P＜0.05).(4)Multivariate Logistic regression analysis showed that NLR,SII,SIRI and AISI were risk factors for the disease severity of elderly CKD complicated with CAS(P＜0.05 or P＜0.01).(5)ROC curve analysis showed that NLR,SII,SIRI and AISI all had high value in evaluating the disease severity of elderly CKD complicated with CAS,with statistically significant differences(P＜0.001).Conclusion NLR,SII,SIRI and AISI are all correlated with the disease severity of elderly CKD complicated with CAS,and they may become potential biological indicators for TCM microscopic syndrome differentiation and disease severity assessment of elderly CKD complicated with CAS.