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探讨中国系统性红斑狼疮患者间质性肺病的相关潜在因素,并建立风险预测模型。

Investigating the potential associated factors and developing a risk model for interstitial lung disease in Chinese patients with systemic lupus erythematosus.

机构信息

Department of Rheumatology, Liuzhou People's Hospital, Guangxi Medical University, Liuzhou, China.

Department of Rheumatology, First Affiliated Hospital of Baotou Medical College, Baotou, China.

出版信息

Lupus. 2023 Jul;32(8):993-1000. doi: 10.1177/09612033231182747. Epub 2023 Jun 20.

DOI:10.1177/09612033231182747
PMID:37338524
Abstract

OBJECTIVE

This study aimed to explore the risk factors for interstitial lung disease (ILD) in Chinese patients with systemic lupus erythematosus (SLE).

PATIENTS AND METHODS

This study recruited 40 SLE patients with ILD (SLE-ILD) and 40 SLE patients without ILD (SLE-non-ILD). Clinical data were collected from all patients, including basic clinical characteristics, affected organ systems, biochemical indexes, autoantibodies, and immunocytes.

RESULTS

Compared with the SLE-non-ILD patients, SLE-ILD patients presented older age ( < 0.001), dry cough ( = 0.006), "velcro-like" crackles ( = 0.021), Raynaud's phenomenon ( = 0.040), elevated complement 3 (C3) level ( = 0.044), and lower SLE disease activity index score ( = 0.013) and cluster of difference-3 cell count ( = 0.043). Multivariate logistic regression analysis showed that older age ( < 0.001, odds ratio [OR]: 1.212), female sex ( = 0.022, OR: 37.075), renal involvement ( = 0.011, OR: 20.039), C3 level ( = 0.037, OR: 63.126), immunoglobulin (Ig) M level ( = 0.005, OR: 5.082), and positive anti-U1 small ribonucleoprotein antibody (anti-nRNP) result ( = 0.003, OR: 19.886) were independent ILD risk factors in SLE patients. Consequently, the ILD risk model in patients with SLE was constructed based on statistically significant variables from the multivariate logistic regression analysis, which significantly correlated with ILD risk, with an area under the curve of 0.887 (95% confidence interval: 0.815-0.960) using receiver operating characteristic curve analysis.

CONCLUSION

Age, female sex, renal involvement, C3 level, IgM level, and a positive anti-nRNP result are independent risk factors for ILD. Furthermore, their combination model is closely associated with an increased ILD risk in Chinese patients with SLE.

摘要

目的

本研究旨在探讨中国系统性红斑狼疮(SLE)患者发生间质性肺病(ILD)的危险因素。

方法

本研究纳入了 40 例系统性红斑狼疮合并间质性肺病(SLE-ILD)患者和 40 例系统性红斑狼疮无间质性肺病(SLE-non-ILD)患者。收集所有患者的临床资料,包括基本临床特征、受累器官系统、生化指标、自身抗体和免疫细胞。

结果

与 SLE-non-ILD 患者相比,SLE-ILD 患者年龄更大(<0.001)、干咳(=0.006)、“捻发音”(=0.021)、雷诺现象(=0.040)、补体 3(C3)水平升高(=0.044)、SLE 疾病活动指数评分较低(=0.013)和差异聚类 3 细胞计数较低(=0.043)。多因素 logistic 回归分析显示,年龄较大(<0.001,比值比[OR]:1.212)、女性(=0.022,OR:37.075)、肾脏受累(=0.011,OR:20.039)、C3 水平(=0.037,OR:63.126)、免疫球蛋白(Ig)M 水平(=0.005,OR:5.082)和抗 U1 小核核糖核蛋白抗体阳性(抗-nRNP)(=0.003,OR:19.886)是 SLE 患者发生 ILD 的独立危险因素。因此,基于多因素 logistic 回归分析的统计学显著变量,构建了 SLE 患者的 ILD 风险模型,该模型与 ILD 风险显著相关,曲线下面积为 0.887(95%置信区间:0.815-0.960),采用接受者操作特征曲线分析。

结论

年龄、女性、肾脏受累、C3 水平、IgM 水平和抗-nRNP 阳性是 ILD 的独立危险因素。此外,它们的组合模型与中国 SLE 患者 ILD 风险增加密切相关。

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