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基于高分辨率计算机断层扫描分级的代谢因素对系统性硬化症合并严重间质性肺病的影响

Influence of metabolic factors on systemic sclerosis complicated with severe interstitial lung disease based on high-resolution computed tomography grading.

作者信息

Qian Chengyu, Liu Jinling, Xie Jingzhi, Yin Hanqiu, Wang Linsheng, Yin Songlou, Zhou Dongmei

机构信息

Department of Rheumatology, The Affiliated Hospital of Xuzhou Medical University, No.99 Huaihai West Road, Xuzhou, 221002, China.

The First Clinical Medicine School, Xuzhou Medical University, Xuzhou, 221002, China.

出版信息

Clin Rheumatol. 2025 Apr;44(4):1617-1624. doi: 10.1007/s10067-025-07305-2. Epub 2025 Feb 15.

Abstract

OBJECTIVES

Systemic sclerosis complicated with interstitial lung disease (SSc-ILD) is a rare autoimmune disease with a dismal prognosis. To analyze the common clinical indicators of systemic sclerosis (SSc) complicated with severe interstitial lung disease (ILD) patients based on the grading of lung high-resolution computed tomography (HRCT) and to explore the risk factors of severe (ILD).

METHODS

A retrospective analysis was performed on 72 newly diagnosed and treated SSc-ILD patients in the Affiliated Hospital of Xuzhou Medical University from June 2013 to August 2023. The interstitial lung disease was divided into grades 1, 2, and 3 according to the HRCT images. Grades 1 and 2 were classified as a non-severe group (42 cases), and grade 3 was a severe group (30 cases). The general data and laboratory examination results of the two groups were analyzed. A logistic regression model was established, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of risk factors for severe SSc-ILD patients.

RESULTS

Patients in the severe group had lower height (1.610 ± 0.059 vs 1.574 ± 0.078, P = 0.031), triglyceride (TG) (1.796 ± 0.743 vs 1.265 (1.04, 1.63), P = 0.026) and total protein (TP) (77.96 ± 8.784 vs 72.709 ± 8.042, P = 0.011)than those in the non-severe group. The area under the curve of height, TG, and TP combined with the diagnosis of systemic sclerosis complicated with severe interstitial lung disease was 0.839, and the sensitivity and specificity were 0.750 and 0.781, respectively.

CONCLUSION

Low TG and TP may be the risk factors for SSc patients with severe interstitial lung disease. Therefore, it is promising as a potential therapeutic target for SSc-ILD and warrants appropriate follow-up in further studies of patients. Key Points • We hoped to pay attention to the influence of metabolic factors on connective tissue disease complicated with interstitial lung disease due to the relationship between metabolism and immunity is complicated.

摘要

目的

系统性硬化症合并间质性肺疾病(SSc-ILD)是一种预后较差的罕见自身免疫性疾病。基于肺部高分辨率计算机断层扫描(HRCT)分级分析系统性硬化症(SSc)合并严重间质性肺疾病(ILD)患者的常见临床指标,并探讨严重ILD的危险因素。

方法

对2013年6月至2023年8月在徐州医科大学附属医院新诊断并治疗的72例SSc-ILD患者进行回顾性分析。根据HRCT图像将间质性肺疾病分为1级、2级和3级。1级和2级归为非严重组(42例),3级为严重组(30例)。分析两组的一般资料和实验室检查结果。建立逻辑回归模型,绘制受试者工作特征(ROC)曲线,评估危险因素对严重SSc-ILD患者的预测价值。

结果

严重组患者的身高(1.610±0.059 vs 1.574±0.078,P = 0.031)、甘油三酯(TG)(1.796±0.743 vs 1.265(1.04,1.63),P = 0.026)和总蛋白(TP)(77.96±8.784 vs 72.709±8.042,P = 0.011)低于非严重组。身高、TG和TP联合诊断系统性硬化症合并严重间质性肺疾病的曲线下面积为0.839,敏感性和特异性分别为0.750和0.781。

结论

低TG和低TP可能是SSc合并严重间质性肺疾病患者的危险因素。因此,它有望成为SSc-ILD的潜在治疗靶点,值得在患者的进一步研究中进行适当随访。要点•由于代谢与免疫的关系复杂,我们希望关注代谢因素对合并间质性肺疾病的结缔组织病的影响。

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