在狼性炎中预测脏复发的HALP评分:一个嵌套的病例控制研究
Jeny A Marín-Corte1, Alfredo Atl Castillo-Sigales1, Hilda Fragoso-Loyo2
1Department of Internal Medicine, Hospital General de Zona/Medicina Familiar 29 Belisario Domínguez, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
概括
在狼性炎诊断时,低HALP得分 (血红蛋白-专蛋白-淋巴细胞-血小板) 预测病复发的风险更高. 这一发现有助于识别需要密切监测狼性炎进展的患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 类风湿病学 类风湿病学
- 临床生物标志物 临床生物标志物
背景情况:
- 狼性炎 (LN) 是系统性红斑狼的一种严重并发症.
- 在LN患者中预测性复发 (RR) 对于及时干预至关重要.
- 血红蛋白-白蛋白-淋巴细胞-血小板 (HALP) 评分是一种新的复合生物标志物.
研究的目的:
- 评估HALP评分在诊断LN患者性复发时的预测值.
- 在预测RR时,为HALP得分建立一个最佳的截止值.
- 评估HALP得分和临床结果在LN之间的关联.
主要方法:
- 嵌套病例对照研究涉及成年LN患者,诊断时间在2010-2022年之间.
- 患者分为训练和验证组,每个组都有性复发 (RR) 和非RR组.
- 考克斯回归分析用于确定HALP得分与RR之间的关联.
主要成果:
- 在验证组中确定了23.5的最佳HALP得分切线 (AUC0.896,灵敏度91.9%,特异性97.3%).
- 一个HALP得分≤23.5显着与更高的基线SLEDAI-2K,增加的长期损伤指数和更高的脏活检慢性相关.
- 患有HALP得分≤23.5的患者经历了显著更短的复发时间 (4.2 vs 12.9年).
结论:
- 狼性炎诊断时HALP得分≤23.5是一个独立的病复发风险因素.
- 哈尔普得分作为一个有价值的工具,用于早期识别高风险的LN患者.
- 这种生物标志物可以指导狼性炎的密集监测和治疗策略.
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