|
|
|
| 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 |
|
|
|
|
Abstract Objective: 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.
|
|
|
|
|
|
[1] Aringer M,Petri M.New classification criteria for systemic lupus erythematosus[J].Curr Opin Rheumatol,2020,32(6):590-596.
[2] 苏勤怡,乔军,张升校,等.低密度粒细胞介导的中性粒细胞胞外诱捕网在系统性红斑狼疮中的研究进展[J].中华风湿病学杂志,2021,25(11):774-778.
[3] 殷蕾,茅幼英,周征宇,等.儿童系统性红斑狼疮并发血栓性微血管病的临床特点和早期识别[J].中国小儿急救医学,2021,28(10):868-873.
[4] Wright RD,Bannerman F,Beresford MW,et al.A systematic review of the role of eculizumab in systemic lupus erythematosus-associated thrombotic microangiopathy[J].BMC Nephrol,2020,30(1):245.
[5] 中华医学会风湿病学分会,国家皮肤与免疫疾病临床医学研究中心,中国系统性红斑狼疮研究协作组,等.2020中国系统性红斑狼疮诊疗指南[J].中华内科杂志,2020,59(2):172-185.
[6] 费丹峰,兰兰,任萍萍,等.个体化利妥昔单抗挽救治疗伴急性肾损伤的活动性狼疮肾炎的疗效分析[J].中华肾脏病杂志,2021,37(12):967-973.
[7] Alkhatib MH,Kant S,Menez S,et al.Thrombotic microangiopathy versus class IV lupus nephritis in systemic lupus erythematosus[J].Nephrol,2021,34(6):1907-1913.
[8] Pivovarova AI,Thongprayoon C,Hansrivijit P,et al.Thrombotic microangiopathy among hospitalized patients with systemic lupus erythematosus in the united states[J].Diseases,2020,24(1):3.
[9] Jesus D,Larosa M,Henriques C,et al.Systemic lupus erythematosus disease activity score (sle-das) enables accurate and user-friendly definitions of clinical remission and categories of disease activity[J].Ann Rheum Dis,2021,80(12):1568-1574.
[10] 张军,唐茂芝.55例狼疮性肾炎合并血栓性微血管病变临床危险因素分析[J].第三军医大学学报,2018,40(5):449-453.
[11] Xie X,Wang G,Cheng H,et al.Scleroderma-associated thrombotic microangiopathy in overlap syndrome of systemic sclerosis and systemic lupus erythematosus:a case report and literature review[J].Medicine (Baltimore),2020,9(41):22582.
[12] 张素真,赵旭辉,夏琳芝,等.外周血ADAMT-13,CD154,sTM在SLE合并血栓性微血管病中的水平变化及临床意义[J].中国皮肤性病学杂志,2022,36(2):150-154. |
|
|
|
2022, Vol. 28 
