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类风湿关节炎患者发生肺部感染的危险因素分析 预览

Risk factors for pulmonary infection in patients with rheumatoid arthritis
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摘要 目的分析类风湿关节炎(RA)合并肺部感染的危险因素,并建立感染风险预测模型,为临床预防控制感染提供依据。方法选取2010年1月-2018年2月临床资料完整的RA患者1069例,按照7∶3的比例随机分为建模组749例和验证组320例,采用Epidata 3.0双录入和SPSS 21.0进行数据统计和分析,对建模数据采用单因素和多因素相关性回归分析,基于回归分析结果进一步建立风险预测模型,用受试者工作特征曲线(ROC曲线)和Hosmer-Lemeshow(H-L)拟合优度检验评价模型效果。结果1069例RA患者中,117例发生肺部感染,感染率为10.94%。多因素logistic二元回归分析结果显示年龄、病程、吸烟、2型糖尿病、关节置换术后、血清类风湿因子(RF)阳性是RA患者合并肺部感染的危险因素(P?<0.05)。预测模型S=-2.19+0.79×年龄-1.76×病程+1.36×吸烟史+0.41×糖尿病史-1.37×关节置换术后+4.41×RF。结论对RA患者合并肺部感染进行分析并建立感染预测模型,结果显示RF、病程、关节置换术后和吸烟史是主要的危险因素。 Objective The risk factors for pulmonary infection in patients with rheumatoid arthritis(RA)were analyzed,and a risk prediction model was constructed for better prevention and control of such infections.Methods A total of 1 069 patients with rheumatoid arthritis were identified during the period from January 2010 to February 2018 with complete clinical data.The patients were randomly assigned to model group or validation group in a ratio of 7∶3.The data were entered into Epidata 3.0 via double input and analyzed with SPSS 21.0.The data were subjected to univariate and multivariate correlation and regression analysis,the results of which were used to construct a risk prediction model.The risk prediction model was then validated by the receiver operating characteristic curve(ROC)and Hosmer-Lemeshow test to evaluate its goodness of fit.Results Of the 1 069 RA patients,117(10.94%)had pulmonary infection.Multivariate logistic regression analysis showed that age,duration of disease,smoking,type 2 diabetes mellitus,prior joint replacement,and positive serum rheumatoid factor(RF)were significant risk factors for pulmonary infection in RA patients(P<0.05).Prediction model S=-2.19+0.79×age-1.76×duration of disease+1.36×smoking history+0.41×diabetes history-1.37×joint replacement+4.41×RF.Conclusions This study suggests that serum RF,duration of disease,prior joint replacement,and smoking history are significant risk factors for pulmonary infection in RA patients.A preliminary risk prediction model is established and validated.
作者 黎声飞 伍音 李东升 肖田田 龚媛 罗锋 LI Shengfei;WU Yin;LI Dongsheng;XIAO Tiantian;GONG Yuan;LUO Feng(Department of Rheumatology,People's Hospital of Ganzhou City,Ganzhou Jiangxi 341000,China)
出处 《中国感染与化疗杂志》 CAS CSCD 北大核心 2019年第3期237-242,共6页 Chinese Journal of Infection and Chemotherapy
关键词 类风湿关节炎 肺部感染 危险因素 模型预测 rheumatoid arthritis pulmonary infection risk factor model prediction
作者简介 第一作者:黎声飞(1984-),男,硕士,主治医师,主要从事临床风湿疾病治疗研究;通信作者:罗锋,E-mail:3295119705@qq.com。
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