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基于预测模型对合并肺和肾受累的韦格纳肉芽肿早期死亡情况的分析。

Analysis of early death based on the prediction model in Wegener's granulomatosis with pulmonary and renal involvement.

作者信息

Zycinska K, Wardyn K A, Tyszko P, Otto M

机构信息

Systemic Vasculitis Outpatient Clinic, Department of Family Medicine, Internal and Metabolic Diseases Nephrology Unit, Warsaw Medical University, Warsaw, Poland.

出版信息

J Physiol Pharmacol. 2007 Nov;58 Suppl 5(Pt 2):829-37.

Abstract

The prognosis for patients with Wegener's granulomatosis has improved considerably over the last decades. The aim of the study was to assess the early death risk based on the prediction model in a population-based cohort of 60 patients with Wegener's granulomatosis. Clinical analysis has been conducted using the disease extent index (DEI) and Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) questionnaires for disease activity. Logistic regression analysis and a Wilcoxon test were included into the statistics. Survival time and death risk were assessed using the Kaplan-Meier estimator and the Cox proportional hazard model. An Receiver Operating Characteristic curve or ROC curve was employed to estimate the value of logistic regression. The early death risk was 16 times higher (P<0.02) in the dialyzed patients and 15 times higher (P<0.05) in the patients with cough as compared with the patients without those predicaments. Predictors of early death are: disease duration, hemoglobin concentration, necessity of dialysis and occurrence of cough. Simultaneous renal and respiratory tract involvement is associated with the highest early death risk.

摘要

在过去几十年中,韦格纳肉芽肿患者的预后有了显著改善。本研究的目的是基于预测模型,在一个由60例韦格纳肉芽肿患者组成的人群队列中评估早期死亡风险。使用疾病范围指数(DEI)和韦格纳肉芽肿伯明翰血管炎活动评分(BVAS/WG)问卷对疾病活动进行临床分析。统计分析包括逻辑回归分析和威尔科克森检验。使用Kaplan-Meier估计器和Cox比例风险模型评估生存时间和死亡风险。采用受试者工作特征曲线(ROC曲线)来估计逻辑回归的值。与没有这些情况的患者相比,透析患者的早期死亡风险高16倍(P<0.02),咳嗽患者的早期死亡风险高15倍(P<0.05)。早期死亡的预测因素为:疾病持续时间、血红蛋白浓度、透析必要性和咳嗽的发生。肾脏和呼吸道同时受累与最高的早期死亡风险相关。

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