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系统性红斑狼疮肠炎风险和严重程度的预测模型。

Predictive model of risk and severity of enteritis in systemic lupus erythematosus.

机构信息

Department of Rheumatology and Immunology, 499791Shantou Central Hospital, Shantou, China.

Department of Blood Purification, 499791Shantou Central Hospital, Shantou, China.

出版信息

Lupus. 2022 Sep;31(10):1226-1236. doi: 10.1177/09612033221110743. Epub 2022 Jun 24.

DOI:10.1177/09612033221110743
PMID:35750508
Abstract

INTRODUCTION

To describe the clinical and laboratory features of systemic lupus erythematosus (SLE) enteritis and to establish a predictive model of risk and severity of lupus enteritis (LE).

METHODS

Records of patients with SLE complaining about acute digestive symptoms were reviewed. The predictive nomogram for the diagnosis of LE was constructed by using R. The accuracy of the model was tested with correction curves. The receiver operating characteristic curve (ROC curve) program and a Decision curve analysis (DCA) were used for the verification of LE model. Receiver operating characteristic curve was also employed for evaluation of factors in the prediction of severity of LE.

RESULTS

During the eight year period, 46 patients were in the LE group, while 32 were in the non-LE group. Abdominal pain, emesis, D-dimer >5 μg/mL, hypo-C3, and anti-SSA positive remained statistically significant and were included into the prediction model. Area under the curve (AUC) of ROC curve in this model was 0.909. Correction curve indicated consistency between the predicted rate and actual diagnostic rates. The DCA showed that the LE model was of benefit. Forty-four patients were included in developing the prediction model of LE severity. Infection, SLE disease activity index (SLEDAI), CT score, and new CT score were validated as risk factors for LE severity. The AUC of the combined SLEDAI, infection and new CT score were 0.870.

CONCLUSION

The LE model exhibits good predictive ability to assess LE risk in SLE patients with acute digestive symptoms The combination of SLEDAI, infection, and new CT score could improve the assessment of LE severity.

摘要

简介

描述系统性红斑狼疮(SLE)肠炎的临床和实验室特征,并建立狼疮性肠炎(LE)风险和严重程度的预测模型。

方法

回顾了以急性消化道症状为主诉的 SLE 患者的病历。使用 R 构建 LE 诊断的预测列线图。使用校正曲线检验模型的准确性。使用接收者操作特征曲线(ROC 曲线)程序和决策曲线分析(DCA)验证 LE 模型。ROC 曲线还用于评估预测 LE 严重程度的因素。

结果

在 8 年期间,46 例患者为 LE 组,32 例为非 LE 组。腹痛、呕吐、D-二聚体>5μg/ml、C3 降低和抗 SSA 阳性仍然具有统计学意义,被纳入预测模型。该模型的 ROC 曲线下面积(AUC)为 0.909。校正曲线表明预测率与实际诊断率之间具有一致性。DCA 表明 LE 模型具有获益。44 例患者被纳入 LE 严重程度预测模型的建立。感染、SLE 疾病活动指数(SLEDAI)、CT 评分和新 CT 评分被验证为 LE 严重程度的危险因素。联合 SLEDAI、感染和新 CT 评分的 AUC 为 0.870。

结论

LE 模型对评估以急性消化道症状为主诉的 SLE 患者 LE 风险具有良好的预测能力。SLEDAI、感染和新 CT 评分的联合应用可以提高 LE 严重程度的评估。

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