| Objectives:The clinical data and field epidemiological data of systemic lupus erythematosus(SLE) were studied through multidimensional statistical models to reveal the pathogen of onset,predict the risk of onset and clinical prognosis and provide the foundation for the surveillance and prevention of high risk group of SLE.Methods:(1) SLE hospitalization data was collected from the first attached hospital of Anhui Medical University and the Anhui provincial hospital among twelve years from 1990 to 2001.Under the consideration with the level one of hospitalization episodes and the level two of patients after the pretreatment of the data,we mainly applied the parametric estimation method of MCMC to fit the two-level linear regression model of length of stay(LOS) and two-level logit regression model of therapeutic effectiveness according to total and female SLE patients,frailty model of synthetic evaluation of therapeutic quality,two-level factor analysis model of multiple response variables to classified the immunity substances, time series model of the number of SLE patients according to total and female SLE patients.(2) Epidemiological data of SLE patients with their family members was collected from March to June of 2004 based on the unit of family. Under the consideration with the level one of patients and the level two of families after the pretreatment of the data,we applied the parametric estimation method of MCMC to fit the two-level logit model to predict the risk of onset according to total and female SLE patients. Results:(1) Two models of LOS of total and female SLE were all collective on the level of patients in which the former was the two-level random coefficient model and the latter was the two-level variance component model. The influence factors of the former included:types of drugs often used, family location,situation of admission,if coming from the other section offices,nosocomial infection,if occurred firstly,anti URNP antibody, anti Sm antibody and complement C3,in which the variable of types of drugs often used had the random effect on the level of patients.While the influence factors of the latter included:situation of admission, nosocomial infection,if treated with hormone before admission,IgG, complement C3 and the frequency of abortion.The affections of common factors were not all identical.According to the former,LOS of patients treated with six,four,three and two types of drugs were all longer than that of those patients treated with hormone only.(2) There had no correlation among the therapeutic effectiveness of several hospitalization episodes of a same SLE patient or female SLE patient.Influence factors of the therapeutic effectiveness of total ShE patients included:types of drugs often used,situation of admission,temperature and IgG.Except of temperature,the other three factors had effects on the therapeutic effectiveness of female SLE patients with different affections. Therapeutic effectiveness of patients treated with six,four,three and two types of drugs were all better than that of those patients treated with hormone only.(3) Synthetic therapeutic quality of those non-death SLE recurrent patients had random effect on the level of patients with a homogeneous frailty which was a Weibull model with Gamma distribution of frailty.Sex,if coming from the other section offices,nosocomial infection,if treated with hormone before admission,IgG and types of drugs often used had effects on the synthetic therapeutic quality of those non-death SLE recurrent patients.Synthetic therapeutic quality of those patients treated with hormone only was better than that of those treated with combined therapied.(4) It was found from the two-level factor analysis model of normal response variables that the factors were collected on the level of patients based on which IgG,IgA and ESR were classed as one category and IgM and C3 as the other.The two-level factor analysis model of binary response variables was fit and found that the factors were not collected on the level of patients based on which anti URNP antibody,anti Sm antibody and antinuclear antibody were classed as one category and anti SSA antibody and anti ds-DNA antibody as the other.(5) Forty-seven series of the numbers of SLE patients was divided yearly and quarterly.The lastly determined time series model of the numbers of SLE patients was ARIMA(1, 0,2) after plotting the series graph,distinguishing,comparing and diagnosing the several models.It was found from this ARIMA model that there had a high degree of auto-ccrrelation among the series values of SLE patients yearly and quarterly with the coefficient of auto-correlation of 0.9631.A certain series value was affected by the one before last. Prediction model of the numbers of total SLE patients were similar to the one of the numbers of female SLE patients.(6) The onset of SLE of female SLE patients had no congregation in families.Pathogenic factors of total SLE patients were sex,group of age,diastolic pressure,allergic history and job occupation.Age,diastolic pressure,allergic history and job occupation were pathogenic factors of female SLE patients.The affections of common factors were different.According to the former,the risk of onset of the ages from 18 to 25 was the highest.While according to the latter, the risk of onset was decreasing with the increase of age. Conclusions:According to the different goals and different scopes of objects of studies,diverse statistical models could be applied to do analysis and prediction on the LOS,therapeutic effectiveness,synthetic therapeutic quality,the number of hospitalization patients and risk of onset.Two-level factor analysis model of the immunity substances should be re-fit after the complete data were replenished.All the statistical predictive models should be repeatedly verified by a new set of SLE data before applied in the actual work of clinics and prevention. |
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