Department of Rheumatology, Renji Hospital South Campus, Shanghai Jiaotong University School of Medicine, Shanghai, 201112, China.
Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China.
Sci Rep. 2020 Apr 14;10(1):6400. doi: 10.1038/s41598-020-63476-9.
Systemic lupus erythematosus (SLE) gastrointestinal (GI) complication is characterized by multi-segment and multi-compartment involvement. The aim of this study is to develop a computed tomography (CT) image-based system for disease evaluation. SLE patients with GI involvement from two independent cohorts were retrospectively included. Baseline abdominal CT scan with intravenous and oral contrast was obtained from each individual. A CT scoring system incorporating the extent of GI tract involvement and intestinal wall thickness, along with extra-GI compartment involvement, was developed and validated. The outcome measurement was the time to GI functional recovery, defined as the time to tolerable per os (PO) intake ≥50% of ideal calories (PO50). A total of 54 and 37 patients with SLE GI involvement were enrolled in the derivation and validation cohorts, respectively. The CT scores for SLE GI involvement were positively correlated with patients' time to PO50 (r = 0.57, p < 0.0001, derivation cohort; r = 0.42, p = 0.0093, validation cohort). Patients with a CT score ≤ 3 had a shorter time to PO50 (median time of 0 day) in pooled cohort, whereas those with a CT score > 3 incurred a significantly prolonged recovery with a median time to PO50 of 13 days (p < 0.0001). The CT-based scoring system may facilitate more accurate assessment and individualized management of SLE patients with GI involvement.
系统性红斑狼疮（SLE）胃肠道（GI）并发症的特点是多节段和多腔室受累。本研究旨在开发一种基于计算机断层扫描（CT）图像的疾病评估系统。回顾性纳入了来自两个独立队列的有胃肠道受累的 SLE 患者。从每个个体中获取基线腹部 CT 扫描，静脉和口服造影剂。开发并验证了一种 CT 评分系统，该系统结合了胃肠道受累的程度和肠壁厚度以及胃肠道外腔室受累的情况。结局测量是胃肠道功能恢复的时间，定义为耐受口服（PO）摄入≥理想卡路里的 50%（PO50）的时间。共有 54 名和 37 名 SLE 胃肠道受累患者分别纳入了推导队列和验证队列。SLE GI 受累的 CT 评分与患者达到 PO50 的时间呈正相关（推导队列 r=0.57，p<0.0001；验证队列 r=0.42，p=0.0093）。在汇总队列中，CT 评分≤3 的患者达到 PO50 的时间更短（中位时间为 0 天），而 CT 评分>3 的患者恢复时间明显延长，中位时间为 13 天（p<0.0001）。基于 CT 的评分系统可能有助于更准确地评估和个体化管理有胃肠道受累的 SLE 患者。
