Wobser Hella, Paur Tanja, Schnoy Elisabeth, Hartl Janine, Kirchner Gabriele I
University Hospital of Regensburg, Department of Internal Medicine and Gastroenterology, Regensburg, Germany.
United European Gastroenterol J. 2018 Mar;6(2):247-254. doi: 10.1177/2050640617711632. Epub 2017 May 18.
Several years ago the International Autoimmune Hepatitis Group simplified the previous for diagnosis of autoimmune hepatitis (AIH) into a scoring system based on only four instead of 13 parameters.
We aimed to evaluate the suitability of the AIH score for diagnosis of AIH in a German cohort with chronic liver diseases.
In this retrospective single-center study, we compared the accuracy of both AIH scores in 70 patients with AIH and 211 patients with chronic liver diseases (PBC ( = 52), PSC ( = 27), NASH ( = 67), DILI ( = 15), CHB/C ( = 50)). Sensitivity, specificity and predictability of each scoring system were calculated.
Using the AIH score, the sensitivity and specificity of detecting a AIH (scores ≥ 6) were 96% and 97% with a positive and negative predictive value of 92% and 99%, respectively. For diagnosis of AIH (scores ≥ 7), the sensitivity and specificity were 43% and 100% with a positive and negative predictive value of 97% and 84%, respectively. The concordance with the criteria was 63%. The specificity for excluding AIH was excellent in both scoring system.
The diagnostic criteria allow a reliable diagnosis of AIH in a German cohort.
数年前，国际自身免疫性肝炎小组将先前用于自身免疫性肝炎（AIH）诊断的标准简化为一个仅基于4个而非13个参数的评分系统。
我们旨在评估简化的AIH评分在德国慢性肝病队列中对AIH诊断的适用性。
在这项回顾性单中心研究中，我们比较了简化的AIH评分在70例AIH患者和211例慢性肝病患者（原发性胆汁性胆管炎（PBC）（=52例）、原发性硬化性胆管炎（PSC）（=27例）、非酒精性脂肪性肝炎（NASH）（=67例）、药物性肝损伤（DILI）（=15例）、慢性乙型肝炎/丙型肝炎（CHB/C）（=50例））中的准确性。计算了每个评分系统的敏感性、特异性和可预测性。
使用简化的AIH评分，检测到明确AIH（评分≥6）的敏感性和特异性分别为96%和97%，阳性预测值和阴性预测值分别为92%和99%。对于确诊AIH（评分≥7），敏感性和特异性分别为43%和100%，阳性预测值和阴性预测值分别为97%和84%。与原标准的一致性为63%。在两个评分系统中，排除AIH的特异性都很好。
简化的诊断标准能够在德国队列中对AIH进行可靠诊断。
