简化自身免疫性肝炎评分在德国队列中用于自身免疫性肝炎诊断的适用性。
Suitability of the simplified autoimmune hepatitis score for the diagnosis of autoimmune hepatitis in a German cohort.
作者信息
Wobser Hella, Paur Tanja, Schnoy Elisabeth, Hartl Janine, Kirchner Gabriele I
机构信息
University Hospital of Regensburg, Department of Internal Medicine and Gastroenterology, Regensburg, Germany.
出版信息
United European Gastroenterol J. 2018 Mar;6(2):247-254. doi: 10.1177/2050640617711632. Epub 2017 May 18.
BACKGROUND
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.
OBJECTIVE
We aimed to evaluate the suitability of the AIH score for diagnosis of AIH in a German cohort with chronic liver diseases.
METHODS
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.
RESULTS
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.
CONCLUSION
The diagnostic criteria allow a reliable diagnosis of AIH in a German cohort.
背景
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。
目的
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。
方法
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。
结果
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。
结论
简化的诊断标准能够在德国队列中对AIH进行可靠诊断。
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