IgG4相关性疾病的临床特征及住院费用分析

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

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13808.15(6968.50,24652.09)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。

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 13808.15(6968.50,24652.09)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.