Luqmani R A, Bacon P A, Moots R J, Janssen B A, Pall A, Emery P, Savage C, Adu D
Department of Rheumatology, University of Birmingham, Edgbaston, West Midlands, UK.
QJM. 1994 Nov;87(11):671-8.
The continuing morbidity of patients with vasculitis, despite the improved prognosis with aggressive therapy, underlines the need for accurate disease assessment. We have devised a clinical index of disease activity, and evaluated its use in several forms of necrotizing vasculitis. The weighted score is based on symptoms and signs in nine separate organ systems. Disease features are only scored if they are attributable to active vasculitis. The Birmingham Vasculitis Activity Score (BVAS) was compared with two other published vasculitis activity scores, with the physician's global assessment (PGA), with outcome, and with serological markers of disease activity. In a cross-sectional study of 213 consecutive patients with different forms of vasculitis, all 107 vasculitis patients who were judged completely well on clinical assessment had a BVAS score of 0. Twenty-two patients with active vasculitis prior to treatment had a median score of 7.5 (range 4-30) and 69 with active disease on treatment had a median score of 10 (1-29). Of the 12 who died, median score immediately prior to death was 20.5 (9-30). In a serial prospective study, 30 cases had documented episodes of active disease. During periods of disease activity, the median BVAS values were significantly higher than in remission (15 [range 3-32] vs. 0 [0-2], p < 0.001); the same was true for CRP values (80 [9-361] vs. 13.5 [5-68], p < 0.001). This was not true for erythrocyte sedimentation rate (ESR), haemoglobin (Hb) or von Willebrand factor (VWF).(ABSTRACT TRUNCATED AT 250 WORDS)
尽管积极治疗能改善血管炎患者的预后，但患者持续存在的发病率凸显了准确疾病评估的必要性。我们设计了一种疾病活动临床指数，并评估了其在几种坏死性血管炎中的应用。加权评分基于九个不同器官系统的症状和体征。仅当疾病特征可归因于活动性血管炎时才进行评分。将伯明翰血管炎活动评分（BVAS）与另外两个已发表的血管炎活动评分、医生的整体评估（PGA）、预后以及疾病活动的血清学标志物进行了比较。在一项对213例连续的不同形式血管炎患者的横断面研究中，所有107例经临床评估判定完全康复的血管炎患者的BVAS评分为0。22例治疗前有活动性血管炎的患者中位数评分为7.5（范围4 - 30），69例治疗时有活动性疾病的患者中位数评分为10（1 - 29）。在12例死亡患者中，死亡前的中位数评分为20.5（9 - 30）。在一项系列前瞻性研究中，30例有记录的活动性疾病发作。在疾病活动期，BVAS中位数显著高于缓解期（15 [范围3 - 32] 对比 0 [0 - 2]，p < 0.001）；CRP值也是如此（80 [9 - 361] 对比 13.5 [5 - 68]，p < 0.001）。红细胞沉降率（ESR）、血红蛋白（Hb）或血管性血友病因子（VWF）并非如此。（摘要截选至250字）
