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第45卷第9期
               ·1280 ·                           南 京    医 科 大 学 学         报                        2025年9月


             (续表1)
                               Variable                  CTD⁃nonPAH(n=95)        CTD⁃PAH(n=52)        P
                  Haemorrhages[n(%)]                                            0                     0.200
                    None                                    52(54.7)0000        0.027(51.9)
                    1-2 loops/nailfold                      33(34.7)0000        0.015(28.8)
                    3-6 loops/nailfold                       9(9.5)0000         0.006(11.5)
                    ≥7 loops/nailfold                        1(1.1)0000         0.004(7.8)
                  Subpapillary venous plexus visibility[n(%)]                                         0.593
                    Not visible                             64(67.4)0000        0.035(67.3)
                    1 row visible                           17(17.9)0000        0.008(15.4)
                    2 row visible                           10(10.5)0000        0.008(15.4)
                    >2 rows,dilated                          4(4.2)0000         0.001(1.9)
                  Morphology score[M(P25,P75)]             2.00(1.15,5.05)0     02.70(1.15,5.50)      0.331
                  Flow pattern score[M(P25,P75)]           0.60(0.20,2.60)0     00.80(0.20,2.60)      0.390
                  Pericapillary score[M(P25,P75)]          1.90(0.40,2.80)0     02.40(0.80,3.92)      0.039
                  Semi⁃quantitative assessment[n(%)]                                                  0.762

                    Normal                                   7(7.4)0000         0.003(5.8)
                    Essentially normal                       9(9.5)0000         0.003(5.8)
                    Mild abnormal                           27(28.4)0000        0.012(23.1)
                    Major abnormal                          26(27.4)0000        0.015(28.8)
                    Severe abnormal                         26(27.4)0000        0.019(36.5)
                 CTD:connective tissue disease;SLE:systemic lupus erythematosus;SS:Sjögren’s syndrome;SSc:systemic sclerosis;RA:rheumatoid arthritis;
              OCTD:undifferentiated connective tissue disease;MCTD:mixed connective tissue disense;PVR:pulmonary vascular resistance;CO:cardiac output;CI:
              cardiac index;mRAP:mean right atrial pressure;SvO2:venous oxyhaemoglobin saturation;RBC aggregation:red blood cell aggregation.

                                          表2 Logistic回归分析CTD患者发生PAH危险因素
                        Table 2 Logistic regression analysis of risk factors for the development of PAH in patients with CTD
                              Variable                     β            OR            95%CI             P
                  Disease type(SSc/MCTD)                 0.883         2.419        0.880-6.646        0.087
                  Capillary loop length(per 50 μm increase)  0.006     1.300        1.100-1.500        0.005
                  Pericapillary score                    0.237         1.268        1.025-1.568        0.029


             (图 3)。平均绝对误差(median absolute deviation,            2.4  不同危险分层的 PAH 患者甲襞微循环的临床
              MAD)=0.027,均方误差(mean square error,MSE)=           特征
              0.00109。校准曲线斜率近 1,说明模型预测 CTD 患                         根据 2021 年“中国肺动脉高压诊断与治疗指
              者发生PAH与实际发生风险一致性较好。                               南”推荐采用危险分层量表作为PAH患者危险分层


                                             0    10   20   30   40   50   60   70   80   90   100
                           Points
                                                          0
                           SSc/MCTD or not
                                             1
                           Capillary length(μm)
                                             50  100  150  200  250  300  350  400  450  500  550  600  650
                           Pericapillary Score
                                             0   1  2   3  4   5  6  7   8  9   10
                           Total points
                                             0    20   40   60   80   100  120  140  160  180  200
                           Linear predictor
                                                -2.5 -2.0 -1.5 -1.0 -0.5  0  0.5  1.0  1.5  2.0  2.5  3.0  3.5
                           Predicted value
                                                  0.1   0.2  0.3 0.4 0.5 0.6 0.7  0.8  0.9
                                         图1   Nomogram构建CTD患者发生PAH风险预测模型
                      Figure 1 Nomogram for predicting the risk of PAH development in patients with connective tissue disease
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