Kallenberg Cees G M
Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Clin Rev Allergy Immunol. 2008 Oct;35(1-2):5-10. doi: 10.1007/s12016-007-8065-7.
Systemic vasculitides are a group of diverse conditions characterized by inflammation of the blood vessels. To obtain homogeneity in clinical characteristics, prognosis, and response to treatment, patients with vasculitis should be classified into defined disease categories. Many classification schemes have been proposed, but the American College of Rheumatology (ACR) criteria and the Chapel Hill definitions for the systemic vasculitides are most widely used. The ACR criteria for classifying a patient with vasculitis within a specific disease entity are useful in clinical practice; but, in many cases, their application results in overlapping diagnoses, particularly in patients with small vessel vasculitis and classical polyarteritis nodosa (PAN). The Chapel Hill definitions cannot be used as classification criteria in clinical practice. A recently developed algorithm for the antineutrophil-cytoplasmic-autoantibodies-associated vasculitides and PAN, based both on the Chapel Hill definitions and the ACR criteria and in which clinical data and serological findings are included, proved useful for correctly classifying patients. The use of this algorithm together with the definitions for the large vessel vasculitides may result in a more unifying approach to the classification of the primary systemic vasculitides.
系统性血管炎是一组以血管炎症为特征的多种病症。为了在临床特征、预后及对治疗的反应方面实现同质化,血管炎患者应被分类到明确的疾病类别中。已经提出了许多分类方案,但美国风湿病学会(ACR)标准和系统性血管炎的查珀尔希尔定义应用最为广泛。ACR用于在特定疾病实体中对血管炎患者进行分类的标准在临床实践中很有用;但是,在许多情况下,其应用会导致诊断重叠,特别是在小血管血管炎和经典结节性多动脉炎(PAN)患者中。查珀尔希尔定义在临床实践中不能用作分类标准。最近开发的一种针对抗中性粒细胞胞浆自身抗体相关血管炎和PAN的算法,该算法基于查珀尔希尔定义和ACR标准,并纳入了临床数据和血清学检查结果,已证明对正确分类患者很有用。将该算法与大血管血管炎的定义一起使用,可能会为原发性系统性血管炎的分类带来更统一的方法。