IgG4相关性疾病的临床特征及住院费用分析

吕志杰; 吴丽; 张红霞; 杜平

doi:10.16766/j.cnki.issn.1674-4152.003048

IgG4相关性疾病的临床特征及住院费用分析

doi: 10.16766/j.cnki.issn.1674-4152.003048

吕志杰¹,
吴丽²,
张红霞³,
杜平^4, ,

1.
浙江大学医学院附属邵逸夫医院钱塘院区临床药学室，浙江杭州 310016
2.
浙江中医药大学附属第一医院临床评价中心，浙江杭州 310006
3.
浙江大学医学院附属邵逸夫医院消化内科，浙江杭州 310000
4.
浙江大学医学院附属邵逸夫医院钱塘院区消化内科

基金项目:

浙江省医药卫生科技计划项目 2022KY833

杭州市卫生科技计划项目 A20210514

详细信息

通讯作者:
杜平，E-mail: duping1986@zju.edu.cn

中图分类号: R593
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- 文章访问数: 377
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- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2022-03-12
- 网络出版日期: 2023-08-26

Analysis of the clinical characteristics and hospitalization costs of IgG4-related diseases

1.
Clinical Pharmacy Office, Qiantang Campus, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China

摘要

摘要: 目的分析42例IgG4相关疾病(IgG4-RD)的临床特征及住院费用，为早期诊断及合理控费提供参考。方法回顾收集2016年10月—2021年10月浙江大学医学院附属邵逸夫医院收治的42例IgG4-RD患者的临床资料，并进行统计分析。结果 42例患者中，患者器官受累数为1~5个，最常见的受累器官为胰腺(42.86%)、胆道(26.19%)、淋巴(30.95%)，患者IgG4-RD应答指数(IgG4-RD RI)为5.5(3.0, 7.0)，器官受累数目与血清IgG4和RI呈正相关关系。单用糖皮质激素治疗者28例，激素联合免疫抑制剂者10例，2例患者病情未予药物治疗，2例患者拒绝激素治疗，33例患者对药物治疗反应良好，治疗后血清IgG4、红细胞沉降率(ESR)及IgG4-RD RI均较前下降。IgG4-RD患者住院费用为13 808.15(6 968.50, 24 652.09)元，药品治疗类因子、手术材料类因子、辅助检查类因子是影响IgG4-RD患者住院费用的3个公因子。结论 IgG4-RD是一组好发于中老年男性、多器官受累且高度可治疗的系统性疾病，血清IgG4及IgG4-RD RI可作为临床诊断及治疗评价的重要参考指标。可从西药费、手术材料费和检查费等途径合理控制IgG4-RD患者的住院费用。
- IgG4相关疾病 /
- 血清IgG4 /
- 受累器官 /
- 诊断 /
- 治疗 /
- 住院费用
Abstract: Objective To analyze the clinical characteristics and hospitalization costs of 42 IgG4-related diseases (IgG4-RD) patients, so as to provide reference for improving early diagnosis and reasonable cost control. Methods Clinical data of 42 IgG4-RD patients admitted to Sir Run Run Shaw Hospital Zhejiang University School of Medicine from October 2016 to October 2021 were retrospectively collected for statistical analysis. Results Among the 42 patients, the number of involved organ was 1 to 5, and the most common organs were pancreas (42.86%), biliary (26.19%), lymphatic (30.95%), the interquartile range of IgG4-RD responder index was 5.5(3.0, 7.0) and the number of involved organ was positively associated with serum of IgG4 and IgG4-RD responder index (IgG4-RD RI). There were 28 patients treated with glucocorticoids alone, 10 patients treated with glucocorticoids combined with immunosuppressant, 2 patients were not given drug treatment, 2 patients refused glucocorticoids treatment, 33 patients responded well to drug treatment, and serum of IgG4, erythrocyte sedimentation rate (ESR) and IgG4-RD RI decreased compared with previous treatment. The median hospitalization cost of IgG4-RD patients was 13 808.15 (6 968.50, 24 652.09) yuan. Drug treatment factors, surgical material factors, and co-examination factors were the three public factors affecting the hospitalization cost of patients with IgG4-RD. Conclusion IgG4-RD is a group of systemic diseases that occurs well in middle-aged and elderly men, with multiple organ involved and is highly treatable. Serum of IgG4 and IgG4-RD RI can be used as important reference indicators for clinical diagnosis and therapeutic evaluation. The hospitalization costs of IgG4-RD patients can be reasonably controlled from western medicine costs, surgical materials costs and examination costs.
- IgG4-related diseases /
- Serum of IgG4 /
- Involved organs /
- Diagnosis /
- Treatment /
- Hospitalization costs

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表 1 治疗前后血清IgG4、ESR及IgG4-RD RI比较[M(P₂₅, P₇₅)]

Table 1. Comparison of serum IgG4, ESR and IGG4-RD RI before and after treatment [M(P₂₅, P₇₅)]

项目	治疗前	治疗后	Z值	P值
血清IgG4(g/L)	6.95(3.33, 15.34)	2.11(1.14, 3.65)	4.714	<0.001
ESR(mm/h)	36(16, 71)	9(4, 19)	4.099	<0.001
IgG4-RD RI	5.5(3.0, 7.0)	2.0(1.0, 4.0)	5.076	<0.001

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表 2 住院费用构成情况

Table 2. Composition of hospitalization costs

类别	金额(元)	构成比(%)
材料费	149 337.4	17.76
检查费	122 680.7	14.59
化验费	148 423.6	17.66
中药费	3 743.4	0.45
西药费	229 270.9	27.28
手术费	48 276.8	5.74
治疗费	61 126.5	7.27
护理费	26 959.5	3.21
诊疗费	9 205.0	1.09
床位费	29 965.0	3.56
其他费	11 666.6	1.39

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表 3 因子解释原有变量的总方差

Table 3. Factors explain the total variance of the original variables

成分	初始特征值			提取载荷平方和			旋转载荷平方和
成分	特征值	方差百分比(%)	累积(%)	特征值	方差百分比(%)	累积(%)	特征值	方差百分比(%)	累积(%)
1	4.824	43.850	43.850	4.824	43.850	43.850	3.241	29.461	29.461
2	1.852	16.836	60.686	1.852	16.836	60.686	2.837	25.789	55.250
3	1.300	11.815	72.502	1.300	11.815	72.502	1.898	17.252	72.502
4	0.915	8.320	80.822
5	0.751	6.829	87.651
6	0.446	4.057	91.708
7	0.402	3.658	95.366
8	0.259	2.352	97.718
9	0.119	1.083	98.801
10	0.084	0.762	99.563
11	0.048	0.437	100.000

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表 4 最大方差法旋转后因子负荷矩阵

Table 4. Maximum variance method factor load matrix after rotation

类别	旋转后的成分矩阵
类别	1	2	3
材料费		0.710
检查费			0.862
化验费	0.744
中药费	0.476
西药费	0.918
手术费		0.848
治疗费	0.889
护理费	0.771
诊疗费		0.770
床位费			0.809
其他费		0.813

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