Page 58 - 南京医科大学自然版

第45卷第2期
·198 · 南 京 医 科 大 学 学 报 2025年2月

sive worsening of respiratory distress over one month， tributed continuous variables，median and interquartile
［35-36］
along with one of the following conditions ：① acute range［M（P25，P75）］for non⁃normally distributed con⁃
worsening of dyspnea requiring hospitalization or sup⁃ tinuous variables，and numbers（percentages）［n（%）］
plemental oxygen；② a decrease in forced vital capac⁃ for categorical variables. The univariate Cox analysis
ity（FVC）of more than 10% or a decrease in diffusing was performed followed by multivariate analysis. Step⁃
capacity of the lungs for carbon monoxide（DLCO） wise regression was used to screen variables based on
with FVC greater than 15% ；③ an increase in the univariate analysis（P < 0.100）to identify independent
extent of interstitial lung lesions over 20% based on risk factors affecting RPILD and survival. The diagnos⁃
chest HRCT；④ respiratory failure or a decrease in tic and prognostic values of NLR and SII were calculated
partial pressure of oxygen over 10 mmHg based on the using the receiver operating characteristic（ROC）curve
arterial blood gas analysis. Two professional radiolo⁃ analysis and the area under the curve（AUC）. Survival
gists evaluated all HRCT images. All patients enrolled analysis was calculated using the Kaplan⁃Meier meth⁃
in the study were sampled for laboratory test prior to od，and the log⁃rank test was used to compare survival
receiving systemic drug therapy from the center. The curves. All statistical tests were two⁃sided，and a P⁃val⁃
current study was approved by the Institutional Review ue of less than 0.05 was considered statistically signifi⁃
Board of the First Affiliated Hospital of Nanjing Medi⁃ cant.
cal University（Jiangsu Provincial Hospital）（ethics
2 Results
No.2020⁃SR⁃265）.
1.2 Data collection 2.1 Baseline clinical characteristics
Demographic，clinical，and laboratory data as well A total of 126 patients were initially enrolled in
as baseline glucocorticoid doses were collected and an⁃ the current study，while two cases with gastric adeno⁃
alyzed. Baseline laboratory data included white blood carcinoma and pancreatic adenocarcinoma（no new tu⁃
cell count（WBC），absolute neutrophil count（NEU）， mor events observed during the follow⁃up period）were
absolute lymphocyte count（LYC），absolute monocyte included，two cases excluded because of missing core
count（MON），platelet count（PLT），alanine amino⁃ data. The mean follow⁃up duration in the current study
transferase（ALT），aspartate aminotransferase（AST）， was 13.23 months，with a median disease duration of
lactate dehydrogenase（LDH），creatine kinase（CK）， 5.36 months. The mean age of the patients was（51.82±
erythrocyte sedimentation rate（ESR），C⁃reactive pro⁃ 13.33）years，and 49 cases（49/124，39.52% ）were
tein（CRP），serum ferritin（SF），fibrinogen（FIB），D⁃di⁃ male. During the follow⁃up period，12 patients（12/124，
mer（D⁃D），myositis⁃specific antibodies（MDA5 anti⁃ 9.68% ）did not develop ILD，75 patients（75/124，
bodies），and myositis⁃associated antibodies（Ro52 anti⁃ 60.48% ）developed ILD but not RPILD，and 37 pa⁃
bodies）. All glucocorticoids were converted to predni⁃ tients（37/124，29.84%）developed RPILD. The mortality
sone⁃equivalent doses. Follow⁃up time was calculated rate in patients with RPILD was 78.38% ，whereas in
from the first visit to our center to death or the last fol⁃ the non⁃RPILD patients，it was 21.62%（P < 0.001）.
low⁃up. NLR was defined as the NEU divided by LYC. Meanwhile，the 3⁃month，6⁃month and 12⁃month all⁃
［37］
SII was defined as（PLT×NEU）/LYC . cause mortality rate were found to have significantly
1.3 Statistical analysis significant differences between the two groups（P <
All data analyses were performed using R version 0.001）（Table 1）.
4.1.3. The Shapiro ⁃ Wilk test was used for normality The patients were divided into the non ⁃ RPILD
testing. The t⁃test or Wilcox rank⁃sum test was applied and RPILD groups. We found statistically significant
for continuous variables with skewed distributions，and differences between the two groups in terms of age，
the Chi⁃square test or Fisher’s exact test was used for LYC，PLT，AST，LDH，CRP，SF，NLR and SII. Specifi⁃
categorical variables. The data were presented as fol⁃ cally，compared with those in the non⁃RPILD group，
lows：mean ± standard deviation（x ± s）for normally dis⁃ patients in the RPILD group were older［（55.73 ±