原发性胆汁性胆管炎合并干燥综合征的危险因素分析及预测模型构建

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Abstract：ObjectiveToinvestigate theriskfactorsassociatedwiththecoexistenceofSjgren’ssydrome（SS）inpatientswith primarybiliarycholangitis（PBC），andtodevelopandcomparediagnosticprediction models forthecomorbidityof the two conditions.MethodsAtotalof183patientsfirstdiagnosedwithPBCatTheFirstAfiliatedHospitalofSoochowUniversityfrom January2012toApril2O23were included.Theyweredividedintotwo groupsbasedonthepresenceorabsenceofSS：thosewith PBCalone （ n =96）and those with PBC accompanied by SS （ n =87）.Clinical manifestations，serological antibody results，and laboratory parameters were compared between the two groups. Continuous data were compared using the t -testorMann-Whitney U test，whilecategoricaldatawerecomparedusingthech-squaretestTeriskfactorsforthepresenceofSSinPBCwereidentified throughamultivariableLogisticregresionanalysis.Subsequently，anartificial neural network（ANN）modelandamultiple logisticregression（MLR）modelwereconstructed topredictthe presenceofSinPS.Thereceiveroperatingcharacteristiccurve was plotedin MedCalc，and the area under thecurve（AUC）was compared using the Delongtest.ResultsSerum IgG level （oddsratio [OR]=1.600 ， 95% confidence interval [CI]：1.364-1.876，P<0.001） was an independent risk factor，while serum totalbilirubin level wasan independent protective factor against the presence of SS inpatients withPBC.TheAUCsoftheANNmodelandtheMLRmodel diagnosing SS inPBC were0.919（95%CI：0.870—0.954） and0.896（95%CI：0.843—0.936），respectively，bothshowing good predictiveeffcacy，andthepredictiveeffcacyof the ANN model was significantly beter than that of the MLR model （ P=0.0192 ）.Conclusion Patients with PBC complicated by SS usually presentatanearlystage with mild symptoms during theirinitial medical consultation，whenearlydiagnosisandtreatmentare beneficialfortheirprognosis.Forpatients withPBCshowing highserum IgGlevelsatthefirstdiagnosisorconsultation，SS screening is necessary.

KeyWords：Primary Biliary Cholangitis；Sjogren’sSyndrome;Risk Factors

Research funding：Suzhou Basic Research Pilot Program（SSD2024033）；Suzhou Young Top Talent Program in Healthcare （GSWS2020018）

原发性胆汁性胆管炎（primarybiliarycholangitis，PBC）是一种慢性胆汁淤积性肝病，特征为胆管上皮细胞肉芽肿性破坏及炎症浸润，最终引发胆汁淤积和肝纤维化[1-2]。（剩余11188字）