Papa M Z, Rabi I, Adar R
Department of General and Vascular Surgery, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Eur J Vasc Endovasc Surg. 1996 Apr;11(3):335-9. doi: 10.1016/s1078-5884(96)80081-5.
The literature on thromboangiitis obliterans (TAO, Buerger's disease) suffers from the lack of a unified method of establishing the diagnosis of the disease. The aim of this study was to test the application of a point scoring system (PSS) in the diagnosis of TAO.
Points are awarded for young age at onset, foot claudication, upper extremity involvement, superficial vein thrombosis and vasospastic phenomena. Atypical features detract points, and the resultant score classifies the diagnosis of TAO as being of low, medium or high probability. One hundred and seven patients diagnosed and classified according to our previous accepted criteria for TAO, were independently reclassified by the PSS, and the results of the two diagnostic processes were compared.
Of the 107 patients diagnosed by our old criteria (OC) the diagnosis of TAO was rejected by the PSS in 20 patients. Of the remaining 87 patients the degree of certainty in the diagnosis (PSS vs. OC) was lower in 31 equal in 47 and higher only in nine.
The proposed PSS is more discriminating than our OC. If this type of scoring system can be agreed upon the certainty in the diagnosis of TAO would be increased. Data collection would be improved, and the cause of clinical and basic research would be advanced.
关于血栓闭塞性脉管炎（TAO，伯格氏病）的文献缺乏统一的疾病诊断方法。本研究的目的是测试积分系统（PSS）在TAO诊断中的应用。
根据发病时年龄较轻、足部间歇性跛行、上肢受累、浅静脉血栓形成和血管痉挛现象来计分。非典型特征会扣分，最终得分将TAO诊断分为低、中、高概率。107例根据我们之前公认的TAO标准进行诊断和分类的患者，通过PSS进行独立重新分类，并比较两种诊断过程的结果。
在107例按旧标准（OC）诊断的患者中，PSS排除了20例TAO诊断。在其余87例患者中，诊断的确定性程度（PSS与OC相比）在31例中较低，在47例中相当，仅在9例中较高。
所提出的PSS比我们的OC更具鉴别力。如果这种计分系统能够得到认可，TAO诊断的确定性将会提高。数据收集将得到改善，临床和基础研究的病因也将得到推进。
