2026 年第 8 期 第 21 卷

系统性红斑狼疮伴狼疮性肠系膜血管炎的危险因素及风险预测模型

Risk factors and risk prediction model of systemic lupus erythematosus complicated with lupus mesenteric vasculitis

作者：胡彩云1张雨欣1沈海丽2

英文作者：Hu Caiyun1 Zhang Yuxin1 Shen Haili2

单位：1兰州大学第二临床医学院，兰州730030；2兰州大学第二医院风湿免疫科，兰州730030

英文单位：1The Second Clinical Medical School Lanzhou University Lanzhou 730030 China; 2Department of Rheumatology and Immunology the Second Hospital Lanzhou University Lanzhou 730030 China

关键词：系统性红斑狼疮；狼疮性肠系膜血管炎；危险因素；列线图

英文关键词：Systemiclupuserythematosus;Lupusmesentericvasculitis;Riskfactors;Nomogram

• 摘要：

• 目的 分析系统性红斑狼疮（SLE）合并狼疮性肠系膜血管炎（LMV）的临床特征，探讨其危险因素，构建并验证风险预测模型。方法 回顾性选取2023年1月至2025年12月兰州大学第二医院风湿免疫科住院的136例SLE患者，根据腹部影像学结果分为对照组（未合并LMV，86例）和观察组（合并LMV，50例）。收集并比较2组临床资料。采用单因素及多因素Logistic回归分析确定独立影响因素，构建列线图预测模型。通过受试者工作特征曲线、校准曲线及决策曲线分析（DCA）评估其效能。结果 2组患者性别、年龄、SLE病程及SLE疾病活动指数2000评分比较差异均无统计学意义（均P>0.05）。观察组腹痛、恶心、呕吐、腹泻、狼疮性肾炎、狼疮性浆膜炎发生率、甘油三酯、红细胞沉降率、C反应蛋白、D-二聚体、24 h尿蛋白定量及抗ds-DNA抗体阳性率均显著高于对照组；白蛋白、高密度脂蛋白胆固醇及补体C3水平均显著低于对照组，差异均有统计学意义（均P＜0.05）。观察组的腹部影像学主要表现为肠壁增厚（98.0%）、腹水（86.0%）和肠系膜脂肪密度增高（76.0%）。多因素Logistic回归分析显示，白蛋白、补体C3是SLE患者并发LMV的独立保护因素，而D-二聚体（比值比=2.122，95%置信区间：1.248~3.610，P=0.006）是独立危险因素。基于三者构建的列线图模型区分度高，校准度佳，DCA显示在较宽阈值范围内具有临床净收益。结论 SLE合并LMV以腹痛为主要表现，常合并狼疮性肾炎及浆膜炎等其他系统受累，腹部影像学检查对临床诊断具有重要价值。低白蛋白、低补体C3及高D-二聚体水平是其发生的独立影响因素，基于此构建的联合预测模型具有辅助临床识别的价值。

• Objective To analyze the clinical characteristics of systemic lupus erythematosus (SLE) complicated with lupus mesenteric vasculitis (LMV), explore its risk factors, and establish and verify a risk prediction model. Methods A total of 136 inpatients with SLE in the Department of Rheumatology and Immunology, the Second Hospital, Lanzhou University from January 2023 to December 2025 were retrospectively enrolled and divided into control group (without LMV, 86 cases) and observation group (with LMV, 50 cases) according to abdominal imaging findings. Clinical data of the two groups were collected and compared. Univariate and multivariate Logistic regression analyses were used to identify independent influencing factors, and a nomogram prediction model was constructed. Its efficacy was evaluated by receiver operating characteristic curve, calibration curve and decision curve analysis (DCA). Results There were no significant differences in gender, age, disease duration of SLE and SLE disease activity index 2000 score between the two groups (all P>0.05). The incidence rates of abdominal pain, nausea, vomiting, diarrhea, lupus nephritis and lupus serositis, levels of triglyceride, erythrocyte sedimentation rate, C-reactive protein, D-dimer, 24 h urinary protein quantification and positive rate of anti-dsDNA antibody in the observation group were significantly higher than those in the control group; levels of albumin, high-density lipoprotein cholesterol and complement C3 were significantly lower than those in the control group (all P<0.05). The main abdominal imaging manifestations in the observation group were intestinal wall thickening (98.0%), ascites (86.0%) and increased mesenteric fat density (76.0%). Multivariate Logistic regression analysis showed that albumin and complement C3 were independent protective factors for LMV in SLE patients, while D-dimer (odds ratio=2.122, 95% confidence interval: 1.248-3.610, P=0.006) was an independent risk factor. The nomogram model constructed based on the three factors showed high discrimination and good calibration, and DCA revealed clinical net benefit within a wide threshold range. Conclusion SLE complicated with LMV mainly presents with abdominal pain, often accompanied by other systemic involvements such as lupus nephritis and serositis. Abdominal imaging examination is of great value for clinical diagnosis. Hypoalbuminemia, hypocomplementemia C3 and elevated D-dimer are independent influencing factors for its occurrence, and the combined prediction model constructed based on these factors is valuable for assisting clinical identification.