Hunder G G
Department of Internal Medicine/Rheumatology, Mayo Clinic, Rochester, Minnesota 55901, USA.
Clin Exp Rheumatol. 2000 Jul-Aug;18(4 Suppl 20):S4-5.
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are two common rheumatic diseases occurring in middle-aged and older persons. Their cause is unknown and in neither is there a single specific diagnostic test. As a result a combination of findings is needed for their diagnosis. The American College of Rheumatology has established criteria for the classification of GCA using two methods. These criteria are best used in research studies involving patients with a diagnosis of vasculitis. One method is based on the so-called traditional format. In this method the patient with vasculitis is classified as GCA if he/she manifests any 3 among the list of 5 criteria selected. The second method, the tree format or recursive partitioning method, starts with the clinical finding that best separates patients with GCA from others with vasculitis and then uses other criteria successively to point to a final decision regarding the presence or absence of GCA. Diagnostic criteria for GCA have not been formulated. Diagnostic criteria have been established for PMR by analysis of a series of patients, but in practice most rheumatologists use criteria established informally by consensus.
巨细胞动脉炎（GCA）和风湿性多肌痛（PMR）是发生于中老年人的两种常见风湿性疾病。其病因不明，且两者均无单一的特异性诊断检测方法。因此，它们的诊断需要综合各项检查结果。美国风湿病学会已采用两种方法制定了GCA的分类标准。这些标准最适用于涉及血管炎诊断患者的研究。一种方法基于所谓的传统格式。在这种方法中，如果血管炎患者表现出所选5项标准中的任何3项，那么该患者就被归类为GCA。第二种方法，即树形格式或递归划分法，始于能最有效地将GCA患者与其他血管炎患者区分开来的临床检查结果，然后依次使用其他标准来最终判定是否存在GCA。目前尚未制定GCA的诊断标准。通过对一系列患者的分析已制定了PMR的诊断标准，但在实际操作中，大多数风湿病学家使用的是通过共识非正式确立的标准。
