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[使用新诊断标准对结节性多动脉炎进行重新分类]

[Use of new diagnostic criteria for reclassification of polyarteritis nodosa].

作者信息

Huang Q, Zhao L, Zhou J X, Zhao J L, Xu D, Tian X P

机构信息

Department of Rheumatology, Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Key Laboratory of Rheumatology and Clinical Immunology,Ministry of Education,Beijing 100730,China.

出版信息

Zhonghua Nei Ke Za Zhi. 2021 Mar 1;60(3):239-242. doi: 10.3760/cma.j.cn112138-20200619-00603.

Abstract

With the recognition of antineutrophil cytoplasmic antibodies (ANCA)-related vasculitis and widespread vaccination against viral hepatitis B, the prevalence of polyarteritis nodosa (PAN) varied considerably. In our study, patients diagnosed as polyarteritis nodasa (PAN)based on the 1990 American College of Rheumatology(ACR) criteria were reclassified using 2007 European Medicines Agency(EMA) algorithm modified by 2012 Chapel Hill Consensus Conference(CHCC) definitions, aiming to evaluate the new classification criteria for the diagnosis of PAN. A total of 113 PAN patients admitted to Peking Union Medical College Hospital from January 2002 to December 2018 were retrospectively analyzed, who were classified into three subtypes including 9 patients with cutaneous, 80 with classic and 24 Hepatitis B virus (HBV) associated PAN. All patients were reclassified according to 2007 EMA algorithm using CHCC 2012 definitions. As a result, 7 patients were diagnosed as microscopic polyangiitis(MPA) and 19 patients with unclassified vasculitis based on the new classification criteria. The diagnostic rate of PAN was gradually declined as the classification criteria of vasculitides was update. However, there are quite a few PAN patients in China, whom rheumatologists should pay attention to the early diagnosis and treatment.

摘要

随着抗中性粒细胞胞浆抗体(ANCA)相关血管炎的认知以及乙型病毒性肝炎疫苗的广泛接种,结节性多动脉炎(PAN)的患病率有了显著变化。在我们的研究中,依据1990年美国风湿病学会(ACR)标准诊断为结节性多动脉炎(PAN)的患者,使用经2012年查珀尔希尔共识会议(CHCC)定义修改的2007年欧洲药品管理局(EMA)算法进行重新分类,旨在评估PAN诊断的新分类标准。对2002年1月至2018年12月在北京协和医院住院的113例PAN患者进行回顾性分析,将其分为三个亚型,包括9例皮肤型、80例经典型和24例乙型肝炎病毒(HBV)相关型PAN。所有患者均根据2007年EMA算法并采用CHCC 2012年定义进行重新分类。结果,根据新的分类标准,7例患者被诊断为显微镜下多血管炎(MPA),19例为未分类血管炎。随着血管炎分类标准的更新,PAN的诊断率逐渐下降。然而,中国有相当数量的PAN患者,风湿病学家应重视其早期诊断和治疗。

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