Zhu Dehao, Meng Jianfen, Jia Jinchao, Wang Mengyan, Ma Yuning, Shi Hui, Sun Yue, Liu Honglei, Cheng Xiaobing, Su Yutong, Ye Junna, Chi Huihui, Liu Tingting, Wang Zhihong, Wan Liyan, Zhou Zhuochao, Wang Fan, Chen Xia, Yang Chengde, Hu Qiongyi, Teng Jialin
Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China.
Clin Rheumatol. 2023 Jan;42(1):187-195. doi: 10.1007/s10067-022-06340-7. Epub 2022 Aug 27.
To compare the ability of the modified Systemic Manifestation Score (mSMS) and the mPouchot score to distinguish adult-onset Still's disease (AOSD) with high disease severity in a large cohort.
We scored the disease severity of 174 patients and categorized them into high and low disease severity states. The correlation of mSMS and mPouchot score with ESR, CRP, ferritin, liver function tests, and serum cytokines was investigated. Receiver operator characteristic (ROC) curve and logistic regression analysis were performed to compare the ability of mSMS and mPouchot to distinguish patients with severe AOSD.
Both mSMS and mPouchot score were positively correlated with ESR (both P < 0.001), CRP (both P < 0.0001), and serum ferritin (both P < 0.0001). Moreover, both mSMS and mPouchot score are significantly associated with liver dysfunction and high IL-18 (both P < 0.0001) and IL-6 (both P < 0.01) levels in AOSD patients. Furthermore, the area under curve (AUC) value of mSMS was significantly less than of mPouchot score (0.71 for mSMS, 0.81 for mPouchot score, P < 0.0001). Compared with mPouchot score, mSMS had higher sensitivity (75.64% vs 74.36%) and lower specificity (55.06% vs 76.40%). And mSMS had a worse performance in assessing high disease severity than mPouchot score in logistic analysis.
Both scores are proven as effective to assess disease severity of AOSD. By contrast, mSMS perform worse in assessing high disease severity of AOSD patients than mPouchot score. Key Points • Both modified Systemic Manifestation Score (mSMS) and modified Pouchot score (mPouchot score) positively correlated with ESR, CRP, and serum ferritin of AOSD patients. • Both scores are significantly associated with impaired liver function and high serum cytokine levels. • mSMS had lower discriminative ability than mPouchot score to distinguish high disease severity of AOSD patients.
在一个大型队列中比较改良的全身表现评分（mSMS）和mPouchot评分区分疾病严重程度高的成人斯蒂尔病（AOSD）的能力。
我们对174例患者的疾病严重程度进行评分，并将他们分为疾病严重程度高和低的状态。研究了mSMS和mPouchot评分与红细胞沉降率（ESR）、C反应蛋白（CRP）、铁蛋白、肝功能检查及血清细胞因子的相关性。绘制受试者工作特征（ROC）曲线并进行逻辑回归分析，以比较mSMS和mPouchot区分重度AOSD患者的能力。
mSMS和mPouchot评分均与ESR（均P＜0.001）、CRP（均P＜0.0001）及血清铁蛋白（均P＜0.0001）呈正相关。此外，mSMS和mPouchot评分均与AOSD患者的肝功能障碍以及高白细胞介素-18（IL-18）水平（均P＜0.0001）和IL-6水平（均P＜0.01）显著相关。此外，mSMS的曲线下面积（AUC）值显著小于mPouchot评分（mSMS为0.71，mPouchot评分为0.81，P＜0.0001）。与mPouchot评分相比，mSMS具有更高的敏感性（75.64%对74.36%）和更低的特异性（55.06%对76.40%）。并且在逻辑分析中，mSMS在评估疾病严重程度高的患者方面比mPouchot评分表现更差。
两种评分均被证明可有效评估AOSD的疾病严重程度。相比之下，mSMS在评估AOSD患者疾病严重程度高的方面比mPouchot评分表现更差。要点•改良的全身表现评分（mSMS）和改良的Pouchot评分（mPouchot评分）均与AOSD患者的ESR、CRP和血清铁蛋白呈正相关。•两种评分均与肝功能受损和高血清细胞因子水平显著相关。•mSMS在区分AOSD患者疾病严重程度高的方面比mPouchot评分的判别能力更低。
