系统性狼血红相关的肺动脉高血压的预后模型:CSTAR-PAH队列研究
Jingge Qu1,2, Mengtao Li3, Xiao Zhang4
1Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, State Key Laboratory of Complex Severe and Rare Diseases, Ministry of Science and Technology, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China.
一个新的模型使用临床因素预测狼相关的肺动脉高血压患者的生存率. 该工具有助于风险分层和个性化预后,以更好地管理患者.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
背景情况:
- 系统性红斑狼 (SLE) 与肺动脉高血压 (PAH) 的高死亡率有关.
- 目前的生存预测工具对于SLE相关的PAH (SLE-PAH) 是不够的.
研究的目的:
- 开发一种实际的预后模型,用于预测SLE-PAH患者的长期存活率.
主要方法:
- 一个多中心的纵向队列,包括310名SLE-PAH患者 (2006年11月至2020年2月).
- 使用了考克斯回归和最小绝对收缩和选择运算符 (LASSO).
- 内部验证包括歧视 (C指数) 和校准.
主要成果:
- 81名患者 (26.1%) 在中位数为5.94年的随访期间死亡.
- 最终的模型包含了8个变量:WHO功能类,步行6分钟的距离,肺血管耐药性,eGFR,血小板减少,轻度ILD,NT-proBNP/BNP和直接胆红素.
- 建立了一个经过验证的5年死亡率预测算法 (C指数=0.77).
结论:
- 一个新的SLE-PAH风险分层模型提供了个性化的预后概率.
- 该模型利用了易于获得的临床风险因素.
- 建议对不同人群进行外部验证.
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