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河北医学  2022, Vol. 28 Issue (11): 1911-1914    DOI: 10.3969/j.issn.1006-6233.2022.11.031
  临床研究 本期目录 | 过刊浏览 | 高级检索 |
系统性红斑狼疮继发血栓性微血管病变相关影响因素及其预测模型的构建
王婷, 王丽, 张育安
云南省第三人民医院, 云南 昆明 650011
Construction of Influencing Factors Associated with Thrombotic Microangiopathy Secondary to Systemic Lupus Erythematosus and Its Predictive Model
WANG Ting, WANG Li, ZHANG Yu'an
The Third People's Hospital of Yunnan Province, Yunnan Kunming 650011, China
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摘要 目的: 探讨系统性红斑狼疮(SLE)继发血栓性微血管病变(TMA)相关影响因素及其预测模型。方法: 选取2018年1月至2022年1月我院156例SLE继发TMA患者作为研究组,按照1∶1原则,纳入156例同期SLE患者作为对照组。统计两组临床特征及实验室指标,构建系统性红斑狼疮继发血栓性微血管病变的Logistic回归模型,并基于Logistic回归模型分析建立SLE继发TMA的评分标准,检验其信效度。结果: 研究组SLE病程、SLEDAI评分及外周血Hcy、CD154水平高于对照组,外周血PLT、ADAMTS-13水平低于对照组(P<0.05);SLEDAI评分(OR:16.291)及外周血Hcy(OR:15.175)、PLT(OR:0.670)、CD154(OR:8.851)、ADAMTS-13(OR:0.533)是SLE继发TMA的影响因素(P<0.05);Logistic回归模型预测SLE继发TMA的AUC为0.917,灵敏度为92.95%,特异度为71.15%。参考Logistic回归模型的β值及其变量类型,建立SLE继发TMA评分量表,该量表Cronbach’s α系数为0.840,各因子间及因子与量表总分的相关系数在0.590~0.783,探索性因子分析因子载荷为0.665。结论: SLEDAI评分及外周血Hcy、PLT、CD154、ADAMTS-13水平是SLE继发TMA影响因素,以此构建列线图预测模型有助于预测TMA发生风险,指导临床诊治。
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关键词 系统性红斑狼疮血栓性微血管病变影响因素预测模型    
AbstractObjective: To investigate the influencing factors associated with thrombotic microangiopathy (TMA) secondary to systemic lupus erythematosus (SLE) and its prediction model.Methods: One hundred and fifty-six patients with TMA secondary to SLE in our hospital from January 2018 to January 2022 were selected as the study group, and 156 patients with SLE in the same period were included as the control group according to the 1∶1 principle. The clinical characteristics and laboratory indexes of the two groups were counted to construct a logistic regression model for thrombotic microangiopathy secondary to SLE, and to establish the scoring criteria for TMA secondary to SLE based on logistic regression model analysis to test its reliability. Results:The duration of SLE, SLEDAI score and peripheral blood Hcy and CD154 levels in the study group were higher than those in the control group, and peripheral blood PLT and ADAMTS-13 levels were lower than those in the control group (P<0.05); SLEDAI score (OR: 16.291) and peripheral blood Hcy (OR: 15.175), PLT (OR: 0.670), CD154 (OR: 8.851) and ADAMTS-13 (OR: 0.533) are influencing factors for TMA secondary to SLE ((P<0.05). The logistic regression model had an AUC of 0.917, a sensitivity of 92.95%, and a specificity of 71.15% for predicting TMA secondary to SLE. Referring to the beta values of the logistic regression model and its variable types, the SLE secondary TMA rating scale was developed, which had a Cronbach's alpha coefficient of 0.840, correlation coefficients between the factors and between the factors and the total scale score ranging from 0.590 to 0.783, and an exploratory factor analysis factor loading of 0.665.Conclusion: The SLEDAI score and peripheral blood levels of Hcy, PLT, CD154 and ADAMTS-13 are factors influencing the development of TMA secondary to SLE, so the construction of a line graph prediction model can help predict the risk of TMA and guide clinical management.
Key wordsSystemic lupus erythematosus    Thrombotic microangiopathy    Influencing factors    Predictive model
    
基金资助:云南省教育厅基金,(编号:2017ZDX025)
通讯作者: 王丽   
引用本文:   
王婷, 王丽, 张育安. 系统性红斑狼疮继发血栓性微血管病变相关影响因素及其预测模型的构建[J]. 河北医学, 2022, 28(11): 1911-1914.
WANG Ting, WANG Li, ZHANG Yu'an. Construction of Influencing Factors Associated with Thrombotic Microangiopathy Secondary to Systemic Lupus Erythematosus and Its Predictive Model. HeBei Med, 2022, 28(11): 1911-1914.
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