摘要
目的基于25-羟基维生素D[25-(OH)D]、血清学因子等构建老年类风湿性关节炎合并间质性肺疾病(RA-ILD)的Nomogram预测模型,并进行模型评价。方法选取2020年5月—2022年10月收治的老年类风湿性关节炎(RA)220例,根据是否合并间质性肺疾病将其分为RA-ILD组(51例)和单纯RA组(169例)2组,比较2组一般资料和实验室相关指标[类风湿因子(RF)、抗环瓜氨酸抗体(anti-CCP)、抗角蛋白抗体(AKA)、类风湿关节炎活动度评分(DAS28)]、25-(OH)D、血清学因子[白细胞介素-33(IL-33)、白细胞介素-35(IL-35)、赖氨酰氧化酶样蛋白-2(LOXL-2)、涎液化糖链抗原-6(KL-6)、基质金属蛋白酶-8(MMP-8)]水平,分析老年RA患者25-(OH)D与各血清学因子的相关性,探讨老年RA-ILD发生的影响因素,根据影响因素、25-(OH)D及血清学因子构建老年RA-ILD的Nomogram预测模型,并对该模型进行评价。结果RA-ILD组和单纯RA组RF、DAS28比较差异有统计学意义(P<0.01);RA-ILD组25-(OH)D、IL-35、KL-6低于单纯RA组,IL-33、LOXL-2、MMP-8高于单纯RA组(P<0.05,P<0.01)。老年RA患者25-(OH)D与IL-35、KL-6呈正相关,与IL-33、LOXL-2、MMP-8呈负相关(P<0.05)。25-(OH)D、IL-35、KL-6、IL-33、LOXL-2、MMP-8、RF和DAS28均为老年RA-ILD发生的影响因素(P<0.01)。在Nomogram预测模型中直接获取各预测因素对应得分,得分之和对应的预测概率即为该老年患者RA-ILD发生的风险概率,该模型对老年RA-ILD发生具有良好预测效能,且具有良好校准度。结论基于25-(OH)D、血清学因子等构建老年RA-ILD发生的Nomogram预测模型,预测效能较高、校准度良好。
Objective To establish a nomogram prediction model for rheumatoid arthritis(RA)complicated with interstitial lung disease(RA-ILD)in the elderly based on vitamin 25-(OH)D and serological factors,and to evaluate the model.Methods A total of 220 elderly patients with RA treated in our hospital from May 2020 to October 2022 were selected and divided into RA group(n=169)and RA-ILD group(n=51)according to whether they had interstitial lung disease.The general information and laboratory-related indicators[rheumatoid factor(RF),anti cyclic citrulline peptide antibody(anti CCP),anti keratin antibody(AKA),rheumatoid arthritis disease activity score(DAS28)],the levels of vitamin 25-(OH)D,serological factors[interleukin-33(IL-33),interleukin-35(IL-35),lysyl oxidase-like protein-2(LOXL-2),Krebs Von den Lungen-6(KL-6),and matrix metalloproteinase-8(MMP-8)]were compared between the two groups.The correlation between vitamin 25-(OH)D and serological factors was analyzed,to analyze the influencing factors of the occurrence of RA-ILD.A nomogram prediction model for RA-ILD was constructed based on the influencing factors,vitamin 25-(OH)D and serological factors,and then evaluated.Results There were significant differences in RF and DAS28 scores between RA-ILD group and simple RA group(P<0.01).Vitamin 25-(OH)D,IL-35 and KL-6 in RA-ILD group were lower than those in simple RA group,while IL-33,LOXL-2 and MMP-8 were higher than those in simple RA group(P<0.05,P<0.01).Vitamin 25-(OH)D was positively correlated with IL-35 and KL-6,and negatively correlated with IL-33,LOXL-2 and MMP-8(P<0.05).Vitamin 25-(OH)D,IL-35,KL-6,IL-33,LOXL-2,MMP-8,RF and DAS28 scores were the influential factors in the occurrence of RA-ILD(P<0.01).The prediction probability corresponding to the sum of each prediction factor was the risk probability of RA-ILD occurrence in this patient.This model had high predictive efficacy in RA-ILD and good calibration.Conclusion This nomogram model was established based on 25-(OH)D and serological factors to predict the occurrence of RA-ILD in elderly patients with RA,showing high predictive efficacy and good calibration.
作者
申爽
季忠庶
张悦
孙伟民
SHEN Shuang;JI Zhongshu;ZHANG Yue;SUN Weimin(Department of Laboratory,Huludao Central Hospital,Huludao,Liaoning 125001,China;Department of Medical Administration,Huludao Central Hospital,Huludao,Liaoning 125001,China)
出处
《临床误诊误治》
CAS
2024年第2期63-69,共7页
Clinical Misdiagnosis & Mistherapy
基金
葫芦岛市科技计划项目(2022JH4/08b)。
