摘要
目的 比较 6种成人斯蒂尔病 (adultonsetStill′sdisease ,AOSD)诊断标准的敏感性及特异性。方法 采用 14 0例临床确诊的AOSD患者及 5 8例非AOSD患者的临床及实验室资料 ,对 6种AOSD诊断标准进行严格检测。结果 6种诊断标准的敏感性以Yamaguchi标准为最好 ,但误诊率较高为 12 1% ,特异性以美国风湿病学会 (ARA)的诊断标准为最好 ,但漏诊率较高达 4 2 1% ,准确度及相应价值以Yamaguchi的诊断标准为最好。 结论 临床工作中应充分认识各诊断标准的差异 ,将敏感性较高的诊断标准用于初诊 ,特异性较高的诊断标准用于确诊 ,以降低漏诊率及误诊率。
Objective To compare the sensitivity and the specificity of 6 types of classification criteria for adult onset Still′s disease (AOSD).Methods The study was a retrospective cohort design.140 patients with adult onset Still′s disease and 58 patients with non AOSD rheumatic diseases were included.Data were extracted on clinical and laboratory parameters.Six sets of diagnostic criteria for adult onset Still′s disease were evaluated.Results The most sensitive one (86 4%) is Yamaguchi′s criterion followed by Cush′s criterion (72 1%) and Kahn′s criterion (69 3%).American Rheumatism Association criterion (ARA criterion) has the best specificity (100 0%).Yamaguchi′s criterion has a high rate of misdiagnosis (12 1%) and ARA criterion has a high rate of missed diagnosis (42 1%).The Yamaguchi′s criterion has the best accuracy and relevant value.Conclusion Awareness of these discrepancies in adult onset Still′s disease criteria are crucial to ensure comparability of different series of this condition.We suggest a high sensitivity criteria for preliminary screen diagnosis and a high specificity criteria for confirmation and differential diagnosis.
出处
《中华风湿病学杂志》
CAS
CSCD
2003年第4期208-211,共4页
Chinese Journal of Rheumatology
