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Machine-learning-based models assist the prediction of pulmonary embolism in autoimmune diseases: A retrospective, multicenter study

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中华医学杂志(英文版) 2024年第15期137卷 1811-1822页

作者： Hu Ziwei Hu Yangyang Zhang Shuoqi Dong Li Chen Xiaoqi Yang Huiqin Su Linchong Hou Xiaoqiang Huang Xia Shen Xiaolan Ye Cong Tu Wei Chen Yu Chen Yuxue cai shaozhe Zhong Jixin Dong Lingli Department of Rheumatology and Immunology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Department of Radiology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Department of Rheumatology and Immunology Jingzhou Central Hospital Yangtze University Jinzhou Hubei China Department of Rheumatology and Immunology Zhongnan Hospital Wuhan University Wuhan Hubei China Department of Rheumatology Wuhan No.Hospital Wuhan Hubei China Department of Rheumatology Minda Hospital of Hubei Minzu University Enshi Hubei China Department of Rheumatology and Immunology The First College of Clinical Medical Science China Three Gorges University Yichang Hubei China

Background: Pulmonary embolism (PE) is a severe and acute cardiovascular syndrome with high mortality among patients with autoimmune inflammatory rheumatic diseases (AIIRDs). Accurate prediction and timely intervention play a pivotal role in enhancing survival rates. However, there is a notable scarcity of practical early prediction and risk assessment systems of PE in patients with ***: In the training cohort, 60 AIIRD with PE cases and 180 age-, gender-, and disease-matched AIIRD non-PE cases were identified from 7254 AIIRD cases in Tongji Hospital from 2014 to 2022. Univariable logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) were used to select the clinical features for further training with machine learning (ML) methods, including random forest (RF), support vector machines (SVM), neural network (NN), logistic regression (LR), gradient boosted decision tree (GBDT), classification and regression trees (CART), and C5.0 models. The performances of these models were subsequently validated using a multicenter validation ***: In the training cohort, 24 and 13 clinical features were selected by univariable LR and LASSO strategies, respectively. The five ML models (RF, SVM, NN, LR, and GBDT) showed promising performances, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.962-1.000 in the training cohort and 0.969-0.999 in the validation cohort. CART and C5.0 models achieved AUCs of 0.850 and 0.932, respectively, in the training cohort. Using D-dimer as a pre-screening index, the refined C5.0 model achieved an AUC exceeding 0.948 in the training cohort and an AUC above 0.925 in the validation cohort. These results markedly outperformed the use of D-dimer levels ***: ML-based models are proven to be precise for predicting the onset of PE in patients with AIIRD exhibiting clinical suspicion of *** Registration: ***: ChiCTR2200059599.

关键词： Autoimmune inflammatory rheumatic diseases Pulmonary embolism Predictive model Machine learning

Update on classification,diagnosis,and management of immunoglobulin G4-related disease

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Chinese Medical Journal 2022年第4期135卷 381-392页

作者： Yu Chen shaozhe cai Lingli Dong Hisanori Umehara Department of Rheumatology and Immunology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina Department of Rheumatology and Immunology Nagahama City HospitalOinuichoNagahamaShiga 526-0043Japan

Immunoglobulin G4-related disease(IgG4-RD)is a newly recognized chronic fibro-inflammatory autoimmune disease,and its recognition has been constantly increasing worldwide over the last few years.A correct and timely recognition,as well as appropriate intervention,is crucial for the treatment of *** certain subtypes of IgG4-RD,organ-specific criteria are formulated to make the diagnosis more *** biomarkers have emerged in the recent years to aid the disease diagnosis,its prognosis prediction,as well as therapy response *** recurrence is very common in IgG4-RD,glucocorticoid is still the first-line treatment for the majority of *** factors that affect the likelihood of disease relapse are *** selection strategy of various steroid-sparing agents is still being ***,when patients have special sites involvement leading to severe clinical conditions,surgical operation or interventional therapy should also be *** update on classification,diagnosis,and management of IgG4-RD is provided in the current study to fully elucidate the recommended clinical practice of this mysterious disease.

关键词： IgG4-related disease Review Update Management

系统性红斑狼疮患者血浆正五聚蛋白-3和成纤维细胞生长因子2的表达与疾病活动相关性研究

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中华风湿病学杂志 2021年第3期25卷 176-180,F0003页

作者：杨笙蔡绍哲王秋菊周丽玲沈桂芬华中科技大学同济医学院附属同济医院风湿免疫科武汉430000 长江大学第二临床学院附属荆州中心医院风湿免疫科 434020

目的探讨外周血正五聚蛋白3(PTX3)和成纤维细胞生长因子2(FGF2)的水平与SLE患者的临床表现、免疫学指标和疾病活动度的相关性。方法收集54例SLE患者和34名健康对照者的外周血标本。对SLE患者和健康对照者的一般情况、临床资料、疾病活... 详细信息

目的探讨外周血正五聚蛋白3(PTX3)和成纤维细胞生长因子2(FGF2)的水平与SLE患者的临床表现、免疫学指标和疾病活动度的相关性。方法收集54例SLE患者和34名健康对照者的外周血标本。对SLE患者和健康对照者的一般情况、临床资料、疾病活动度进行相应评估。ELISA法检测外周血中的PTX3和FGF2的浓度。采用t检验、Mann-Whitney U检验和Spearman秩相关进行统计学相关分析。结果与健康对照相比较,SLE患者血浆PTX3水平明显增高[(3191±2423)pg/ml和(755±432)pg/ml,t=5.595,P<0.01],其中血液系统受累患者滴度高于未受累患者[(3810±2840)pg/ml和(2493±1830)pg/ml,t=2.008,P=0.049],并与尿蛋白定量(24 h)(r=0.4986,P=0.0059)及ESR(r=0.376,P=0.007)、SLEDAI评分(r=0.405,P=0.003)呈正相关,与补体C3呈负相关(r=-0.405,P=0.005)。SLE患者FGF2的血浆水平随着PTX3升高(r=0.304,P=0.029),并与SLEDAI评分呈正相关(r=0.326,P=0.019),与C3(r=-0.414,P=0.004)、C4补体(r=-0.451,P=0.007)呈负相关。此外,SLE患者中抗NuA抗体[(138±91)pg/ml和(59±68)pg/ml,t=2.996,P=0.0042]、抗dsDNA抗体[(120±96)pg/ml和(56±58)pg/ml,t=3.583,P=0.0007]和抗-rRNP抗体[(151±109)pg/ml和(63±61)pg/ml,t=3.757,P=0.0004]阳性者FGF2的水平高于阴性患者。结论外周血PTX3和FGF2的水平对于SLE的疾病活动度和临床表型的判断具有指导作用,可以在临床工作中帮助医生更好地做出诊治决策。

关键词：红斑狼疮,系统性疾病活动度五聚蛋白3 成纤维细胞生长因子2 自身抗体

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IgG4相关性疾病的诊治进展

临床内科杂志 2023年第8期40卷 520-524页

作者：高荣芬蔡邵哲董凌莉华中科技大学同济医学院附属同济医院风湿免疫内科武汉430030

IgG4相关性疾病(IgG4-RD)是一种新发现的慢性、纤维炎症性自身免疫性疾病。该病好发于中老年男性,可累及身体的任何组织器官,导致受累脏器肿大、局部解剖结构受压及组织纤维化,进而导致脏器功能受损。本病常与实体肿瘤、慢性感染、淋巴... 详细信息

IgG4相关性疾病(IgG4-RD)是一种新发现的慢性、纤维炎症性自身免疫性疾病。该病好发于中老年男性,可累及身体的任何组织器官,导致受累脏器肿大、局部解剖结构受压及组织纤维化,进而导致脏器功能受损。本病常与实体肿瘤、慢性感染、淋巴瘤等临床表现相似,临床中易漏诊、误诊。因此,对该病及时、准确地识别及合理、规范地诊治至关重要。IgG4-RD需整合临床症状、实验室检查、病理检查、影像学检查结果并积极完善鉴别诊断后综合判断。近年来,得益于人们对本病关注度的提高和各种检测技术的发展,本病的诊断、治疗策略取得了长足的进步。本文综述了近年来IgG4-RD诊断和治疗方面的新进展,以期为人们探索本病的发病机制、新型诊疗靶点等提供线索。

关键词： IgG4相关性疾病诊断治疗