Development of a Risk Nomogram Model for Identifying Interstitial Lung Disease in Patients With Rheumatoid Arthritis.
Development of a Risk Nomogram Model for Identifying Interstitial Lung Disease in Patients With Rheumatoid Arthritis.
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开发用于识别类风湿性关节炎患者间质性肺疾病的风险列线图模型
DOI：
10.3389/fimmu.2022.823669
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
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作者：
类风湿性关节炎(RA)相关性间质性肺病(ILD)的临床特征通常表现为肺部疾病的晚期，这给临床上RA-ILD患者的早期诊断和指导治疗带来了挑战。本研究的目的是构建一个识别类风湿关节炎患者ILD的诺模图。通过纳入223例RA-ILD患者(85例RA-ILD)的血浆基质金属蛋白酶-3(MMP3)水平、人口学特征、临床特征和实验室参数，建立了RA-ILD的识别图。应用单变量分析和多变量Logistic回归分析筛选出诺模图的候选变量。诊断图的准确性通过一致性指数(C-index)、校准图和决策曲线分析(DCA)来衡量。结果显示，无论是训练队列(p=0.0475)还是验证队列(p=0.0006)，RA-ILD患者血浆MMP3蛋白水平均高于非ILD RA患者。经过最终回归分析，男性性别、当前吸烟状况、循环类风湿因子(RF)、C-反应蛋白(CRP)和基质金属蛋白酶-3水平被确定为构建诺模图的危险因素。校正曲线图进一步显示，识别诺模图与实际临床结果具有良好的一致性。在一致性方面，C指数(训练队列和验证队列均为0.826)表明诺模图具有令人满意的区分能力。尽管MMP3的加入未能显著改善DCA测定的正常图的结果，包括循环中的MMP3水平，但增加了正常图对RA患者ILD的诊断准确性。因此，我们提出的模型可以作为一种无创性工具来识别RA患者中的ILD，这可能有助于医生为RA患者做出治疗决策。
The clinical features of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) (RA-ILD) usually manifest to an advanced stage of lung disease, which leads the challenge of early diagnosis and the difficulty in guiding treatments for patients with RA-ILD in clinical settings. The aim of this study was to construct a nomogram for identifying ILD in RA patients. Through the incorporation of the level of matrix metalloproteinase-3 (MMP-3) in plasma, demographics, clinical feature, and laboratory parameters of 223 RA patients (85 RA-ILD) which were grouped as training cohorts and validation cohorts, an identifying nomogram of RA-ILD was built. Candidate variables for the nomogram were screened using univariable analysis and multivariable logistic regression analysis. The accuracy of the diagnostic nomogram was measured via concordance index (C-index), calibration plots, and decision curve analysis (DCA). Results showed that plasma MMP-3 protein was elevated in RA-ILD patients compared with non-ILD RA patients in both training cohorts (p = 0.0475) and validation cohorts (p = 0.0006). Following a final regression analysis, the gender of male, current smoking state, levels of circulating rheumatoid factor (RF), C-reactive protein (CRP), and MMP-3 were identified as risk factors for the construction of the nomogram. The calibration plots further showed a favorable consistency between the identifying nomogram and actual clinical findings. In consistence, the C-index (0.826 for both training cohorts and validation cohorts) indicated the satisfactory discriminative ability of the nomogram. Although the incorporation of MMP-3 failed to significantly improve identified outcomes of the nomogram as determined by DCA, including the level of circulating MMP-3 increased the diagnostic accuracy of the nomogram for ILD in RA patients. Thus, our proposed model can serve as a non-invasive tool to identify ILD in RA patients, which may assist physicians to make treatment decisions for RA patients.
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DOI：
10.3899/jrheum.200863
发表时间：
2021-05
期刊：
The Journal of rheumatology
影响因子：
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作者：
Kronzer VL;Huang W;Dellaripa PF;Huang S;Feathers V;Lu B;Iannaccone CK;Gill RR;Hatabu H;Nishino M;Crowson CS;Davis JM 3rd;Weinblatt ME;Shadick NA;Doyle TJ;Sparks JA
通讯作者：
Sparks JA
DOI：
10.1002/art.38904
发表时间：
2015-01
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
Chen J;Doyle TJ;Liu Y;Aggarwal R;Wang X;Shi Y;Ge SX;Huang H;Lin Q;Liu W;Cai Y;Koontz D;Fuhrman CR;Golzarri MF;Liu Y;Hatabu H;Nishino M;Araki T;Dellaripa PF;Oddis CV;Rosas IO;Ascherman DP
通讯作者：
Ascherman DP
类风湿性关节炎间质性肺疾病的发病率和死亡率：一项基于人群的研究。
影响因子：
--
作者：
Bongartz, Tim;Nannini, Carlotta;Medina-Velasquez, Yimy F.;Achenbach, Sara J.;Crowson, Cynthia S.;Ryu, Jay H.;Vassallo, Robert;Gabriel, Sherine E.;Matteson, Eric L.
通讯作者：
Matteson, Eric L.
DOI：
10.1016/s1470-2045(14)71116-7
发表时间：
2015-04
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Balachandran VP;Gonen M;Smith JJ;DeMatteo RP
通讯作者：
DeMatteo RP
影响因子：
24.3
作者：
Buendia-Roldan, Ivette;Fernandez, Rosario;Selman, Moises
通讯作者：
Selman, Moises