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2016年原发性干燥综合征分类标准:有哪些新内容?

The 2016 classification criteria for primary Sjogren's syndrome: what's new?

作者信息

Franceschini Franco, Cavazzana Ilaria, Andreoli Laura, Tincani Angela

机构信息

Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy.

Clinical and Experimental Science Department, University of Brescia, Brescia, Italy.

出版信息

BMC Med. 2017 Mar 31;15(1):69. doi: 10.1186/s12916-017-0837-1.

Abstract

New 2016 ACR/EULAR classification criteria for primary Sjogren's syndrome (SS) have been developed and endorsed by the ACR. The newly proposed criteria include simple-to-perform items.Two important points of the new criteria should be considered. Firstly, they indicate that either salivary gland biopsy or anti-Ro must be positive in order to corroborate the inflammatory and autoimmune nature of the disease. Secondly, the criteria recognize the systemic nature of SS, namely that patients without salivary or ocular glandular symptoms, but with extraglandular manifestations and B cell activation markers were also included in the SS classification. Additionally, the new criteria modified some technical points. The ocular staining score threshold was increased to 5 due to the higher specificity. The immunological profile includes only anti-Ro antibodies, while positivity for antinuclear antibodies and rheumatoid factor or isolated anti-La was excluded due to a lack of specificity.The 2016 ACR/EULAR criteria are suitable for early identification of SS, providing patients with the opportunity of enrollment in clinical trials for new specific treatment. Although validation has been successful, the real life application of these criteria will test their performance.

摘要

2016年美国风湿病学会(ACR)制定并认可了原发性干燥综合征(SS)的新分类标准。新提出的标准包含易于操作的项目。新准则有两点需要考虑。首先,它们表明为证实疾病的炎症和自身免疫性质,唾液腺活检或抗Ro抗体必须呈阳性。其次,该标准认识到SS的全身性,即无唾液腺或泪腺症状,但有腺体外表现和B细胞活化标志物的患者也被纳入SS分类。此外,新准则修改了一些技术要点。由于特异性更高,眼部染色评分阈值提高到了5分。免疫学特征仅包括抗Ro抗体,抗核抗体和类风湿因子阳性或单独的抗La抗体因缺乏特异性而被排除。2016年ACR/EULAR标准适用于SS的早期识别,为患者提供参与新的特异性治疗临床试验的机会。尽管验证已取得成功,但这些标准在实际应用中将检验其性能。

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