系统性红斑狼疮患者肾损伤相关危险因素logistic回归模型构建及分析  

Construction and analysis of Logistic regression model for risk factors related to renal injury in patients with systemic lupus erythematosus

作　　者：王柳青 李海剑[1] 张红[1] 张濛 魏斐菲 金玉镜 WANG Liuqing;LI Haijian;ZHANG Hong;ZHANG Meng;WEI Feifei;JIN Yujing(Department of Rheumatology and Immunology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院风湿免疫科,河南南阳473000

出　　处：《社区医学杂志》2023年第17期875-879,共5页Journal Of Community Medicine

摘　　要：目的 分析系统性红斑狼疮(SLE)患者肾损伤相关危险因素,为临床制定防治策略提供可靠依据。方法 选取2020-03-01-2022-03-31南阳市中心医院收治的128例SLE患者为研究对象。统计肾损伤发生情况、临床相关资料,并根据肾损伤情况分为SLE组(n=54)、SLE肾损伤组(n=74),logistic回归方程分析影响SLE患者肾损伤的危险因素。结果 128例患者中,74例出现肾损伤,发生率为57.81%。单因素分析结果显示,与SLE组相比,SLE肾损伤组贫血率、白细胞尿率、血尿率、总胆固醇、三酰甘油、疾病活动指数水平较高,血白细胞减少率、血白蛋白、血球蛋白较低,均P<0.05。logistic多因素回归分析结果显示,血球蛋白>平均值(OR=3.327,95%CI为1.237~8.947,P<0.001)、血白蛋白>平均值(OR=3.045,95%CI为1.468~6.315,P<0.001)、总胆固醇>平均值(OR=5.244,95%CI为1.793~15.336,P<0.001)、疾病活动指数>平均值(OR=4.000,95%CI为1.224~13.069,P<0.001)均为SLE患者肾损伤的独立危险因素。似然比χ^(2)检验、Wald χ^(2)检验结果显示,模型构建差异有统计学意义、具有有效性;同时拟合优度检验结果显示,模型拟合效果较好。结论 SLE患者血球蛋白、血白蛋白、总胆固醇等异常升高可加大肾损伤风险,构建logistic多因素回归模型能有效预测肾损伤发生风险。Objective To analyze the risk factors related to renal injury in patients with systemic lupus erythematosus(SLE),and provide a reliable basis for clinical formulation of prevention and treatment strategies.Methods A total of 128 patients with SLE in Nanyang Central Hospital from March 1,2020to March 31,2022were selected,and the incidence of renal injury and clinical data were analyzed.According to the severity of renal injury,they were divided into SLE group(n=54)and SLE renal injury group(n=74).Logistic regression analysis was used to explore the influencing factors of re-nal injury in SLE patients.Results Among 128patients,74had renal injury,with an incidence of 57.81%.Univariate a-nalysis showed that compared with SLE patients,SLE patients with renal injury had higher levels of anemia,leucuria,he-maturia,total cholesterol,triglycerides,and disease activity index,while lower levels of leukopenia,albumin,and globulin(P<0.05);Logistic multivariate regression equation analysis found that serum globulin>average(OR=3.327,95%CI:1.237-8.947,P<0.001),serum albumin>average(OR=3.045,95%CI:1.468-6.315,P<0.001),total cholesterol>average(OR=5.244,95%CI:1.793-15.336,P<0.001),and disease activity index>average(OR=4.000,95%CI:1.224-13.069,P<0.001)were independent risk factors for renal injury in SLE patients;After the likelihood ratio chi-square test and Wald chi-square test,it was found that the model construction was statistically significant and effective,and the goodness of fit test found that the model fitting effect was good.Conclusion Abnormal elevated levels of blood globulin,albumin,and total cholesterol in patients with SLE can increase the risk of renal injury.Constructing a logistic multiple factor regression model can effectively predict the risk of renal injury and provide reliable evidence for clinical pre-vention and treatment.

关 键 词：肾损伤 系统性红斑狼疮 危险因素 回归模型 

分 类 号：R593.241[医药卫生—内科学]