Arnett F C, Edworthy S M, Bloch D A, McShane D J, Fries J F, Cooper N S, Healey L A, Kaplan S R, Liang M H, Luthra H S
American Rheumatism Association, Atlanta, GA 30329.
Arthritis Rheum. 1988 Mar;31(3):315-24. doi: 10.1002/art.1780310302.
The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a "classification tree" schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.
类风湿关节炎（RA）分类的修订标准是通过对262例当代连续研究的RA患者和262例患有除RA之外的其他风湿性疾病（非RA）的对照受试者进行计算机分析制定的。新的标准如下：1）关节及其周围的晨僵在最大程度改善前持续至少1小时；2）医生观察到3个或更多关节区域的软组织肿胀（关节炎）；3）近端指间关节、掌指关节或腕关节肿胀（关节炎）；4）对称性肿胀（关节炎）；5）类风湿结节；6）类风湿因子的存在；7）手和/或腕关节的影像学侵蚀和/或关节周围骨质减少。标准1至4必须存在至少6周。类风湿关节炎由4条或更多标准的存在来定义，无需进一步限定（典型、明确或可能）或排除列表。此外，还给出了一个“分类树”模式，其表现与传统（7条中的4条）模式相同。与非RA风湿性疾病对照受试者相比，新的标准对RA显示出91%-94%的敏感性和89%的特异性。
