白塞病的诊断/分类标准
Diagnosis/Classification Criteria for Behcet's Disease.
作者信息
Davatchi Fereydoun
机构信息
Behcet's Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14117, Iran.
出版信息
Patholog Res Int. 2012;2012:607921. doi: 10.1155/2012/607921. Epub 2011 Sep 27.
Historical Background. The ISG criteria for Behcet's, created in 1990, have excellent specificity, but lack sensitivity. The International Criteria for Behcet's Disease (ICBD) was created in 2006, as replacement to ISG. The aim of this study was to compare their performance. ISG and ICBD Criteria. For ISG oral aphthosis is mandatory. The presence of any two of the following (genital aphthosis, skin lesions, eye lesions, and positive pathergy test) will diagnose/classify the patient as BD. For ICBD, vascular lesions were added, while oral aphthosis is no more mandatory. Getting 3 or more points diagnose/classify the patient as BD (genital aphthosis 2 points, eye lesions 2 points, and the remaining each one point). Performance and Comparison of ISG and ICBD. Their sensitivity, specificity, and accuracy (percent agreement), were tested in three independent cohort of patients from Far-East (China), Middle-East (Iran), and Europe (Germany). The sensitivity for ISG was respectively 65.4%, 78.1%, 83.7% and for ICBD 87%, 98.2%, and 96.5%. The specificity for ISG was 99.2%, 98.8%, 89.5% and for ICBD 94.1%, 95.6%, and 73.7%. The accuracy for ISG was 74.2%, 85.5%, 85.5% and for ICBD 88.9%, 97.3%, and 89.5%. Conclusion. ICBD has better sensitivity, and accuracy than ISG.
历史背景。1990年制定的白塞病国际研究组（ISG）标准具有出色的特异性，但缺乏敏感性。2006年制定了白塞病国际标准（ICBD），以取代ISG标准。本研究的目的是比较它们的性能。ISG和ICBD标准。对于ISG标准，口腔溃疡是必需的。存在以下任意两项（生殖器溃疡、皮肤病变、眼部病变和针刺试验阳性）即可将患者诊断/分类为白塞病。对于ICBD标准，增加了血管病变，而口腔溃疡不再是必需的。获得3分或更多分数可将患者诊断/分类为白塞病（生殖器溃疡2分，眼部病变2分，其余每项1分）。ISG和ICBD的性能及比较。在来自远东（中国）、中东（伊朗）和欧洲（德国）的三个独立患者队列中测试了它们的敏感性、特异性和准确性（一致率）。ISG的敏感性分别为65.4%、78.1%、83.7%，ICBD的敏感性分别为87%、98.2%、96.5%。ISG的特异性为99.2%、98.8%、89.5%，ICBD的特异性为94.1%、95.6%、73.7%。ISG的准确性为74.2%、85.5%、85.5%，ICBD的准确性为88.9%、97.3%、89.5%。结论。ICBD比ISG具有更好的敏感性和准确性。
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