类风湿关节炎患者动脉粥样硬化风险预测模型的 构建与验证

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中图分类号：R593.22 文献标志码：A DOI：10.11958/20251059

Construction and verification of atherosclerosis risk prediction model for rheumatoid arthritis patients

LYU Jing， ZHU Fangying， ZHU Kai， LI Yun， YANG Na， WN Shuyun， ZHONG Miqian^ Departmentoditioalneicine，ezouHosital，QiluHosital，dongUesityeo

Abstract：ObjectiveToconstructarisk prediction model foratherosclerosis （AS）inpatients withrheumatoid arthritis （RA）basedonLass-Logisticregressionanalysisandprovideascientificbasisforindividualized clinical intervention. MethodsThe retrospective clinical data were collcted from 344RA patients，including 86 patients with AS （RA + AS group）and 258patientswith withoutAS（RAgroup）.Theclinical characteristicsand initial laboratorytestresultswere comparedbetweenthetwogroups.Lassoregression wasused toscreen thekeypredictive variables，andLogisticregression wascombined toconstruct thepredictionmode.Thediscriminationof themodel was evaluated through thereceiver operating characteristic （ROC）curve and the area under thecurve（AUC）.The Hosmer-Lemeshow test was used to assess thecalibration，and decision curveanalysis wasused toverifytheclinical applicabilityof themodel.ResultsSeven predictivevariables were identified including RA diseaseduration，DAS28score，C-reactive protein （CRP），triglycerides （TG），high-densityliporoteincholesterol（HD-C），astingbloodglucose（FBG）andypertesion.Theiskpredictiodel forAS in RA patients was：Logit （P） =-2.674+0.605 × RAdisease duration + 0.393×DAS28 sc0re+0.310×CRP+1.346×TG2.289XHDL-C+0.679xFBG+0.711Xhypertension.TheAUCof themodel was0.965 （95%CI：0.943-0.987），andthe Hosmer-Lemeshow test showed χ2 =0.547， P 1.000，indicating good discrimination and calibration.Clinical decision curve analysis showed that the probabilitythreshold ranged from 7% to 92% ，demonstrating high clinical applicability. ConclusionTheASrisk prediction modelconstructedinthisstudyforRA patientscanefectively identifyhigh-risk individuals，supporting the development of personalized prevention and treatment strategies.

Key Words：arthritis，rheumatoid;atherosclerosis;risk factors; prediction model; Lasso Logisticregresion

类风湿关节炎（RA）是一种慢性炎症性自身免疫性疾病，以累及周围关节为主，导致关节疼痛、肿胀、僵硬和功能障碍[1]。（剩余9982字）