狼疮的新诊断标准
New Criteria for Lupus.
机构信息
Division of Rheumatology, Department of Medicine III, University Medical Center and Faculty of Medicine Carl Gustav Carus at the TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
出版信息
Curr Rheumatol Rep. 2020 May 13;22(6):18. doi: 10.1007/s11926-020-00896-6.
PURPOSE OF THE REVIEW
Classification criteria define the patient population for clinical trials and translational studies, but also influence current understanding of the disease. This review attempts to delineate the development from the American College of Rheumatology (ACR) 1982 to the European League Against Rheumatism (EULAR)/ACR 2019 classification criteria for systemic lupus erythematosus (SLE).
RECENT FINDINGS
The new EULAR/ACR classification criteria use antinuclear antibodies (ANA) as an entry criterion. (Non-infectious) fever is the one new criterion. All criteria items now have individual weights (from 2 to 10) and are structured in domains, within which only the highest item is counted. There is one common attribution rule, counting criteria only if there is no more likely alternative explanation. Ten points are sufficient for classification. The new criteria have reached a sensitivity of 96.1% and a specificity of 93.4%. The new EULAR/ACR 2019 classification criteria for SLE build on the previous criteria sets, adding fever only as a new criteria item. The new structure is reflective of the current diagnostic approach and has led to improved statistical performance.
目的综述
分类标准定义了临床试验和转化研究的患者人群，但也影响了对疾病的当前认识。本综述试图描述从美国风湿病学会（ACR）1982 年到欧洲抗风湿病联盟（EULAR）/ACR 2019 年系统性红斑狼疮（SLE）分类标准的发展历程。
最新发现
新的 EULAR/ACR 分类标准将抗核抗体（ANA）作为纳入标准。（非感染性）发热是新的标准之一。现在所有标准项目都有单独的权重（从 2 到 10），并按域结构排列，其中只计算最高的项目。有一个通用归因规则，即仅在没有更可能的替代解释的情况下才计算标准。10 分即可分类。新的标准已经达到了 96.1%的敏感性和 93.4%的特异性。SLE 的新 EULAR/ACR 2019 分类标准建立在前一标准集的基础上，仅增加发热作为新的标准项目。新的结构反映了当前的诊断方法，并导致了统计性能的提高。
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