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               ·202 ·                            南 京    医 科 大 学 学         报                        2025年2月


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                                    表3 anti⁃MDA5 DM患者死亡独立危险因素的单因素和多因素分析
                  Table 3 Univariate and multivariate analysis of the independent risk factors of death in anti⁃MDA5 DM patients
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                                                       Univariate                         Multivariate
                  Variable
                                             P                 HR(95%CI)            P           HR(95%CI)
                  Age                      <0.002      00 000 001.04(1.02-1.07)    0.039      1.03(1.00-1.06)
                  Sex                      <0.632      00 000 001.17(0.61-2.25)     -               -
                  NLR                      <0.001      00 000 001.18(1.11-1.26)     -               -
                  PLR                      <0.076      00 000 001.00(1.00-1.00)     -               -
                  LMR                      <0.018      00 000 000.60(0.39-0.92)    0.129      0.76(0.57-1.08)
                  SII                      <0.001      00 000 001.00(1.00-1.00)    0.002      1.00(1.00-1.00)
                  SIRI                     <0.001      00 000 001.29(1.16-1.45)     -               -
                  AISI                     <0.001      00 000 001.00(1.00-1.00)     -               -
                  Myasthenia               <0.027      00 000 002.07(1.09-3.96)    0.139      1.66(0.85-3.25)
                  Gottron’s sign           <0.986      00 000 001.01(0.52-1.93)     -               -
                  Heliotrope rash          <0.260      00 000 000.69(0.36-1.30)     -               -
                  V sign                   <0.450      00 000 000.76(0.38-1.54)     -               -
                  Shawl sign               <0.375      00 000 000.69(0.30-1.57)     -               -
                  Skin erythema            <0.592      00 000 000.83(0.42-1.65)     -               -
                  Raynaud’s phenomenon     <0.776      00 000 000.75(0.10-5.47)     -               -
                  Periungual erythema      <0.451      00 000 000.71(0.30-1.72)     -               -
                  Arthritis                <0.508      00 000 000.78(0.37-1.64)     -               -
                  Mechanic’s hand          <0.177      00 000 000.61( 0.29-1.25)    -               -
                  Heterotopic calcification  <0.997    00 000 000.00(0-Inf)         -               -
                  Skin ulcer               <0.460      00 000 001.34(0.61-2.94)     -               -
                  Hypertension             <0.619      00 000 001.20(0.58-2.49)     -               -
                  Diabetes                 <0.594      00 000 000.75(0.27-2.13)     -               -
                  Malignant tumor          <0.996      00 000 000.00(0-Inf)         -               -
                  Cardiac involvement      <0.871      00 000 000.91(0.28-2.96)     -               -
                  ILD                      <0.997      78 116 206.82(0-Inf)         -               -
                  Glu                      <0.694      00 000 001.15(0.58-2.29)     -               -
                 PLR:platelet⁃to⁃lymphocyte ratio;NLR:neutrophil⁃to⁃lymphocyte ratio;LMR:lymphocyte⁃to⁃monocyte ratio;SII:systemic immune⁃inflammation
              index;SIRI:systemic inflammation response index;ILD:interstitial lung disease;Glu:glucose;Inf:infinity;CI:confidence interval.


                       A                                           B
                           1.0                                         1.0
                           0.8                                         0.8
                           Sensitivity  0.6   SII                     Sensitivity  0.6   SII

                           0.4
                                              Sensitivity,51.35%
                                              Specificity,78.16%       0.4               Sensitivity,72.97%
                                                                                         Specificity,62.07%
                           0.2                NLP                      0.2               NLP
                                              Sensitivity,56.76%                         Sensitivity,62.16%
                            0                 Specificity,77.01%        0                Specificity,79.31%
                                 00        0.5       1.0                    00        0.5       1.0
                                        1-Specificity                              1-Specificity
                                       图1   NLR和SII在预测RPILD(A)与存活(B)的ROC分析
                            Figure 1  ROC analysis of both NLR and SII in predicting RPILD(A)and survival(B)


              sive extracellular matrix(ECM)in the interstitium,  play a crucial role in this process by releasing elastase
                                              [49]
              leading to an impaired lung function  . Neutrophils  and matrix metalloproteinases to degrade ECM pro⁃
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