Wang Hongyan, Li Xinming, Fang Kechi, Zhu Huaqun, Jia Rulin, Wang Jing
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China.
Institute of Psychology, Chinese Academy of Sciences; Key Laboratory of Mental Health, Chinese Academy of Sciences, Beijing 100101, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Dec 18;56(6):1017-1022. doi: 10.19723/j.issn.1671-167X.2024.06.011.
To stratify systemic lupus erythematosus (SLE) patients clinically, to analyze the clinical characteristics of patients with and without disease activity, and to explore the application va-lue of key clinical indicators in assessing disease activity, as well as to construct an evaluation model.
A retrospective analysis was conducted on clinical data of the SLE patients diagnosed at Peking University People' s Hospital from May 1995 to April 2014. Demographic information, clinical manifestations, laboratory tests, and antibody detection results were collected. The patients were divided into active and inactive groups based on systemic lupus erythematosus disease activity index 2000(SLEDAI-2000)scores. -tests, Mann-Whitney tests, and tests were used to compare the differences between the groups. Spearman correlation analysis was used to evaluate the relevant clinical indicators associated with SLE activity in the active disease group. Based on the results of statistical analysis, a Logistic regression model was constructed, and the performance of the model was evaluated.
No significant differences were found in demographic characteristics between the two groups. In the active disease group, positive rates of antinuclear antibodies (ANA) and anti-double-stranded DNA antibodies (anti-dsDNA) were increased; white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), lymphocytes (LY), total protein (TP), albumin (ALB), and complement 3(C3) levels were significantly decreased; while immunoglobulin A and G levels were markedly elevated. The correlation analysis results showed that hemoglobin, albumin, C3, and complement 4(C4) had higher correlation indices compared with other clinical indicators. Among these, C3 exhibited a certain negative correlation with disease activity. The Logistic regression model based on 12 significantly different indicators ( < 0.05) achieved an accuracy of 91.4%, sensitivity of 94.4%, specificity of 81.0%, and the area under curve (AUC) of the receiver operating characteristic (ROC) was 0.944.
This study comprehensively evaluated a range of clinical indicators related to SLE disease activity, providing a thorough understanding of both laboratory and clinical markers. The Logistic regression model, which was primarily constructed using laboratory test indicators, such as inflammatory markers, immune response parameters, and organ involvement metrics, demonstrated a high degree of accuracy in assessing the disease activity in SLE patients. Consequently, this model might provide a new basis for the diagnosis and treatment of SLE patients, offering significant clinical diagnostic value.
对系统性红斑狼疮(SLE)患者进行临床分层,分析疾病活动与非活动患者的临床特征,探讨关键临床指标在评估疾病活动中的应用价值,并构建评估模型。
对1995年5月至2014年4月在北京大学人民医院确诊的SLE患者临床资料进行回顾性分析。收集人口统计学信息、临床表现、实验室检查及抗体检测结果。根据系统性红斑狼疮疾病活动指数2000(SLEDAI - 2000)评分将患者分为活动组和非活动组。采用t检验、Mann - Whitney检验和χ²检验比较组间差异。Spearman相关性分析用于评估活动期疾病组中与SLE活动相关的临床指标。基于统计分析结果构建Logistic回归模型,并评估模型性能。
两组患者在人口统计学特征上无显著差异。活动期疾病组中,抗核抗体(ANA)和抗双链DNA抗体(抗dsDNA)阳性率升高;白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(HGB)、淋巴细胞(LY)、总蛋白(TP)、白蛋白(ALB)和补体3(C3)水平显著降低;而免疫球蛋白A和G水平明显升高。相关性分析结果显示,与其他临床指标相比,血红蛋白、白蛋白、C3和补体4(C4)具有较高的相关指数。其中,C3与疾病活动呈一定的负相关。基于12个差异有统计学意义的指标(P < 0.05)构建的Logistic回归模型准确率为91.4%,敏感度为94.4%,特异度为81.0%,受试者工作特征曲线(ROC)下面积(AUC)为0.944。
本研究全面评估了一系列与SLE疾病活动相关的临床指标,对实验室和临床标志物有了深入了解。主要使用炎症标志物、免疫反应参数和器官受累指标等实验室检查指标构建的Logistic回归模型在评估SLE患者疾病活动方面具有较高的准确性。因此,该模型可能为SLE患者的诊断和治疗提供新的依据,具有重要的临床诊断价值。