摘要
目的比较2017EULAR/ACR系统性红斑狼疮分类标准和既往标准诊断的价值。方法从近10年门诊及住院最终确诊为SLE患者及非SLE结缔组织病患者中分别随机抽取60例,分为SLE疾病组和非SLE疾病组。对所有患者临床表现及实验室数据按照ACR1997、SLICC2012和2017EULAR/ACR三种不同的SLE分类标准要求进行填表;统计三种分类标准诊断SLE的情况;确诊的SLE患者,按照符合的分类标准数进行统计分析。结果ACR1997分类标准中SLE组与非SLE组比较,抗磷脂抗体和Coombs试验相差不大,差异无统计学意义(P>0.05),其他临床表现差异均十分显著,有统计学意义(P<0.05);SLICC2012中关节炎、抗磷脂抗体和Coombs试验,差异无统计学意义(P>0.05),其他临床表现差异均十分显著,有统计学意义(P<0.05);2017EULAR/ACR中关节炎、抗磷脂抗体和Coombs试验差异无统计学意义(P>0.05),其余各项差异均有统计学意义(P<0.05)。3种分类方法的敏感性分别为0.64、0.86和0.92,特异性分别为0.81、0.67和0.61。确诊SLE患者中,只符合1个分类标准的有9例,符合2个分类标准的有31例,符合3个分类标准的有20例,差异有统计学意义(P<0.05)。结论2017EULAR/ACR SLE分类标准对SLE患者的诊断要优于ACR1997和SLICC2012,具有较高的敏感性,有利于患者的早期诊断,虽然特异性略低前2种标准,但同样值得临床推广。
Objective To compare the value of 2017 EULAR/ACR systemic lupus erythematosus classification criteria and previous criteria diagnosis.Methods Sixty patients were randomly selected from SLE patients and non-SLE connective tissue patients in the past 10 years,and were divided into SLE disease group and non-SLE disease group.The clinical manifestations and laboratory data of all patients were filled according to the three different SLE classification criteria of ACR1997,SLICC2012 and 2017 EULAR/ACR;the three classification criteria were used to diagnose SLE;in accordance with the classification criteria,the confirmed SLE patients were conducted statistical analysis.Results In the classification criteria of ACR1997,there was no significant difference between SLE group and non-sle group in anti-phospholipid antibody and Coombs test,with no statistical significance(P>0.05).Other clinical manifestations showed significant differences,with statistical significance(P<0.05).In SLICC2012,there was no statistically significant difference in arthritis,blood system involvement,anti-phospholipid antibody and Coombs test(P>0.05),while there were significant differences in other clinical manifestations(P<0.05).There were no statistically significant differences in arthritis,anti-phospholipid antibody and Coombs tests in eular/ACR 2017(P>0.05)and all other differences were statistically significant(P<0.05).The sensitivity of the three classification methods were 0.64,0.86,respectively.And 0.92,the specificity was 0.81,0.67 and 0.61 respectively.Among the patients with confirmed SLE,there were 9 cases that met only one classification standard,31 cases that met the two classification criteria,and 20 cases that met the three classification criteria.The difference was statistically significant(P<0.05).Conclusion The classification criteria of eular/ACR SLE in 2017 were better than those of ACR1997 and SLICC2012 in the diagnosis of SLE patients,showing a higher sensitivity and facilitating the early diagnosis of patients.Although the specificity was slightly lower than the previous two criteria,it was still worthy of clinical promotion.
作者
李荣平
谷晓晶
居艳娟
陈琥
孙剑芳
冯雪琴
王飙
郭迪斌
LI Rongping;GU Xiaojing;JU Yanjuan;CHEN Hu;SUN Jianfang;FENG Xueqin;WANG Biao;GUO Dibin(The First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China)
出处
《现代医院》
2019年第12期1821-1823,1826,共4页
Modern Hospitals
基金
江西省卫生计生委科技计划项目(20195403)
