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系统性红斑狼疮患者间质性肺疾病预测模型的开发与外部验证:一项横断面研究。

Development and external validation of a prediction model for interstitial lung disease in systemic lupus erythematosus patients: A cross-sectional study.

作者信息

Xu Wang-Dong, Chen You-Yue, Wang Xiang, Su Lin-Chong, Huang An-Fang

机构信息

Department of Evidence-Based Medicine, School of Public Health, Southwest Medical University, Luzhou, Sichuan, PR China.

Luzhou Meteorological Bureau, 3 Songshan Road, Luzhou, Sichuan, PR China.

出版信息

Semin Arthritis Rheum. 2024 Dec;69:152556. doi: 10.1016/j.semarthrit.2024.152556. Epub 2024 Oct 11.

Abstract

OBJECTIVE

The aim of this study is to develop and validate a nomogram that can assist clinicians in identifying female systemic lupus erythematosus (SLE) patients of reproductive age complicated with interstitial lung disease (ILD).

METHODS

Clinical, laboratory data of SLE patients were first collected. Meteorological data were then gathered according to the geographical locations of the SLE patients. Diagnostic results, univariate logistic regression, elastic net regression, and multivariate logistic regression were used to screen for risk factors for female SLE patients of reproductive age complicated with ILD. A nomogram was constructed using these risk factors and was internally and externally validated through methods such as calculating the concordance index, plotting calibration curves, drawing receiver operating characteristic curves, and clinical decision curves.

RESULTS

A total of 4798 SLE patients were included in this study, with 2488 patients in the development set and 2310 patients in the external validation set. The patients in the development set were randomly divided into a training set (N = 1742) and an internal testing set (N = 746) at a ratio of 7:3. Eight independent risk factors for ILD were identified, including APOB, APOA1, ALP, PLT, HCT, EOS-R, LYM-R, and age. The nomogram model was developed, and the areas under the receiver operating characteristic curve was 0.811 (0.748, 0.875), 0.820 (0.727,0.913), and 0.889 (0.869, 0.909) for the three sets, respectively.

CONCLUSION

We established a nomogram model using easily accessible clinical and laboratory data to predict the probability of female SLE patients of reproductive age developing ILD.

摘要

目的

本研究旨在开发并验证一种列线图,以帮助临床医生识别患有间质性肺病(ILD)的育龄期女性系统性红斑狼疮(SLE)患者。

方法

首先收集SLE患者的临床和实验室数据。然后根据SLE患者的地理位置收集气象数据。采用诊断结果、单因素逻辑回归、弹性网回归和多因素逻辑回归筛选育龄期女性SLE患者合并ILD的危险因素。利用这些危险因素构建列线图,并通过计算一致性指数、绘制校准曲线、绘制受试者工作特征曲线和临床决策曲线等方法进行内部和外部验证。

结果

本研究共纳入4798例SLE患者,其中开发集2488例,外部验证集2310例。开发集中的患者按7:3的比例随机分为训练集(N = 1742)和内部测试集(N = 746)。确定了8个ILD的独立危险因素,包括载脂蛋白B(APOB)、载脂蛋白A1(APOA1)、碱性磷酸酶(ALP)、血小板(PLT)、血细胞比容(HCT)、嗜酸性粒细胞比例(EOS-R)、淋巴细胞比例(LYM-R)和年龄。构建了列线图模型,三个数据集的受试者工作特征曲线下面积分别为0.811(0.748,0.875)、0.820(0.727,0.913)和0.889(0.869,0.909)。

结论

我们利用易于获取的临床和实验室数据建立了一个列线图模型,以预测育龄期女性SLE患者发生ILD的概率。

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