微血流成像对类风湿性关节炎患者艾拉莫德治疗反应性的预测价值  

Predictive value of micro-blood flow imaging in the response of patients with rheumatoid arthritis to lguratimod therapy

作　　者：曾鸽 龙军 蒋俊杰[1] 蔡慧 李巧凤[1] ZENG Ge;LONG Jun;JIANG Junjie;CAI Hui;LI Qiaofeng(Department of Special Inspection Department,Huzhou Third Municipal Hospital,Wenzhou,Zhejiang 313000,China)

机构地区：[1]湖州市第三人民医院特检科,浙江温州313000

出　　处：《中华全科医学》2024年第6期1028-1032,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2021KY1098)。

摘　　要：目的类风湿性关节炎(RA)患者对艾拉莫德的治疗反应与患者预后显著相关,早期识别对艾拉莫德治疗不应答的患者并及时调整治疗方案,对改善预后具有重要意义。基于此,本研究将微血流成像应用于艾拉莫德治疗的RA患者中,并探讨其对RA患者艾拉莫德治疗反应性的预测价值。方法纳入湖州市第三人民医院2022年1月—2023年1月接受艾拉莫德治疗的139例RA患者,根据治疗反应将患者分为应答组(88例)和无应答组(51例)。收集患者治疗前微血流成像资料,采用多因素logistic回归分析筛选RA艾拉莫德治疗不应答的影响因素,构建预测模型,并分析模型预测价值。结果多因素logistic回归分析显示,动脉阻力指数(OR=0.362)、血流分级0级(OR=0.440)、Ⅰ级(OR=0.314)、Ⅱ级(OR=0.120)、红细胞沉降率(ESR,OR=1.117)、疾病活动指数(DAS,OR=1.367)、晨僵时间(OR=1.159)均是RA艾拉莫德治疗不应答的影响因素(P<0.05)。基于上述5项指标构建的预测模型预测RA患者对艾拉莫德治疗不应答的C-index为0.816,AUC为0.816(95%CI:0.808~0.938)。结论动脉阻力指数、血流分级、ESR、DAS、晨僵时间是RA患者艾拉莫德治疗反应的影响因素,基于此构建的预测模型可用于RA患者艾拉莫德治疗不应答发生风险的预测。Objective The response of patients with rheumatoid arthritis(RA)to Elamod therapy is significantly related to their prognosis.It is of great significance to identify patients who do not respond to treatment with Elamod at an early stage and adjust the treatment plan in time.Based on this,this study applied micro-blood flow imaging technology to the patients with RA treated by Elamod,and discussed its predictive value for the curative effect of Erasmus in the treatment of RA patients.Methods A total of 139 patients with RA who received Elamod in the Huzhou Third Municipal Hospital from January 2022 to January 2023 were divided into response group(n=88)and non-response group(n=51)according to their treatment response.The data of micro-blood flow imaging before treatment were collected,and the factors influencing non-response to RA Elamod treatment were screened by multivariate logistic regression,and a prediction model was constructed to analyze the predictive value of the model.Results Multivariate logistic regression analysis showed that high arterial resistance index(OR=0.362),blood flow grade 0(OR=0.440),gradeⅠ(OR=0.314),and gradeⅡ(OR=0.120)were the protective factors for the non-response of RA'Elamod(P<0.05).High ESR(OR=1.117),high DAS score(OR=1.367),and long-term morning stiffness(OR=1.159)were the risk factors(P<0.05).Based on the prediction model of the above five indexes,the C-index and AUC of RA patients who did not respond to Elamod treatment were 0.816 and 0.816(95%CI:0.808-0.938),respectively.Conclusion Pulse resistance index,blood flow classification,ESR,DAS score,and morning stiffness time are the factors influencing treatment response of patients with RA,and the prediction model on them can be used to predict the risk of non-response of RA patients to treatment.

关 键 词：类风湿性关节炎 微血流成像 艾拉莫德 预测价值 

分 类 号：R593.22[医药卫生—内科学] R979.5[医药卫生—临床医学]