McFarlane I G
Institute of Liver Studies, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom.
Can J Gastroenterol. 2001 Feb;15(2):107-13. doi: 10.1155/2001/279637.
In 1998, the International Autoimmune Hepatitis Group--a panel of 40 hepatologists and hepatopathologists from 17 countries who have a particular interest in autoimmune hepatitis (AIH)--undertook a review, in light of subsequent experience, of the descriptive criteria and diagnostic scoring system that it had proposed in 1993 for the diagnosis of AIH. This review (published in 1999) noted that the original descriptive criteria appeared to be quite robust and required only relatively minor modifications to bring them up to date with developments and experience in diagnostic modalities for liver disease in general. Analysis of published data on the application of the original criteria in nearly 1000 patients revealed that the diagnostic scoring system had an overall diagnostic accuracy of 89.8%, with a sensitivity of 98.0%. Specificity for excluding definite AIH in patients with chronic viral hepatitis and circulating autoantibodies or patients with overlapping cholestatic syndromes was 98% to 100%, but specificity for excluding probable AIH in these disorders ranged from only 60% to 80%. Modifications, including adjustments to the weightings against biochemical and histological cholestatic features, have been made to the scoring system to improve its specificity.
1998年，国际自身免疫性肝炎小组——由来自17个国家的40位对自身免疫性肝炎（AIH）有特殊兴趣的肝病学家和肝病理学家组成——根据后续经验，对其于1993年提出的AIH诊断描述标准和诊断评分系统进行了回顾。该回顾（于1999年发表）指出，最初的描述标准似乎相当可靠，只需进行相对较小的修改就能使其跟上肝病诊断方式的发展和经验。对近1000例患者应用原始标准的已发表数据进行分析发现，诊断评分系统的总体诊断准确率为89.8%，敏感性为98.0%。在慢性病毒性肝炎和循环自身抗体患者或重叠胆汁淤积综合征患者中排除明确AIH的特异性为98%至100%，但在这些疾病中排除可能AIH的特异性仅为60%至80%。已对评分系统进行了修改，包括调整针对生化和组织学胆汁淤积特征的权重，以提高其特异性。
