Liao Zetao, Gu Jieruo, Huang Feng, Lin Zhimin, Zhao Like, Yu Buyun
Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou 510630, China.
Joint Bone Spine. 2009 Mar;76(2):146-9. doi: 10.1016/j.jbspin.2008.06.015. Epub 2009 Jan 10.
To evaluate the diagnosing value of the Berlin algorithm, comparing to that of the established ESSG and Amor criteria in Chinese patients with undifferentiated spondyloarthropathy.
A total of 92 clinically diagnosed undifferentiated spondyloarthropathy patients with axial involvement were compared to 123 patients with other kinds of rheumatic diseases by using the parameters listed in the Berlin algorithm, ESSG criteria, and Amor criteria.
In the 92 undifferentiated spondyloarthropathy patients with axial involvement, the prevalence rate of HLA-B27 was 71.76% (61/85). Elevated ESR and/or CRP was found in 40.96% (34/83) SpA patients and abnormal MRI manifestation of sacroiliac joint was found in 91% (39/43) SpA patients. The specificity of HLA-B27 was 78% and similar with the Berlin study. The sensitivity/specificity of ESSG, Amor criteria and Berlin algorithm on diagnosing USpA was 72.83%/92.68%, 64.13%/93.50% and 67.39%/95.93%, respectively. The coincidence between the three diagnosing criteria and the rheumatologist's opinion was moderate.
Our study showed the new Berlin algorithm has important value of diagnosing undifferentiated spondyloarthropathy in China, which has the similar diagnosing capacity comparing to the traditional criteria ESSG and Amor criteria.
评估柏林算法与既定的欧洲脊柱关节病研究组（ESSG）标准及阿莫尔标准相比，对中国未分化脊柱关节病患者的诊断价值。
采用柏林算法、ESSG标准和阿莫尔标准中列出的参数，将92例临床诊断为有轴向受累的未分化脊柱关节病患者与123例其他类型的风湿性疾病患者进行比较。
在92例有轴向受累的未分化脊柱关节病患者中，HLA - B27的患病率为71.76%（61/85）。40.96%（34/83）的脊柱关节炎（SpA）患者血沉和/或C反应蛋白升高，91%（39/43）的SpA患者骶髂关节MRI表现异常。HLA - B27的特异性为78%，与柏林研究相似。ESSG标准、阿莫尔标准和柏林算法对未分化脊柱关节炎（USpA）诊断的敏感度/特异性分别为72.83%/92.68%、64.13%/93.50%和67.39%/95.93%。三种诊断标准与风湿病专家意见之间的一致性为中等。
我们的研究表明，新的柏林算法在中国未分化脊柱关节病的诊断中具有重要价值，其诊断能力与传统标准ESSG和阿莫尔标准相似。
