摘要
目的基于临床病例比较2019年欧洲抗风湿病联盟/美国风湿病学会(European League Against Rheumatism/American College of Rheumatology,EULAR/ACR)、2012年系统性红斑狼疮国际合作临床组织(Systemic Lupus International Collaborating Clinics,SLICC)及1997年美国风湿病学会(American College of Rheumatology,ACR)系统性红斑狼疮(systemic lupus erythematoses,SLE)分类标准间的差异并评估不同分类标准的诊断价值。方法收集2014年1月至2019年12月于贵州医科大学附属医院确诊为SLE病例73例,以其他结缔组织病82例为对照,统计患者各项临床指标及免疫学指标的数据,比较不同分类标准间灵敏度、特异度及ROC曲线下面积的差异。结果EULAR/ACR-2019、SLICC-2012及ACR-1997灵敏度及特异度分别为95.89%、98.63%、73.97%及92.68%、84.15%、98.78%,灵敏度及特异度在三种不同分类标准间存在显著差异,其中ACR-1997灵敏度最低,SLICC-2012特异度最低(P<0.001)。EULAR/ACR-2019、SLICC-2012、ACR-1997之间漏诊率、误诊率相比差异有统计学意义,其中ACR-1997漏诊率最高,但误诊率最低(P<0.05)。EULAR/ACR-2019、SLICC-2012、ACR-1997的ROC曲线下面积(AUC)分别为0.943、0.914、0.864。EULAR/ACR-2019与ACR-1997间AUC差异有统计学意义(P=0.0044),但SLICC-2012与EULAR/ACR-2019及ACR-1997之间AUC的差异无统计学意义(P>0.005)。结论EULAR/ACR-2019的SLE诊断价值优于ACR-1997,但SLICC-2012与EULAR/ACR-2019、ACR-1997相比无明显优势。将EULAR/ACR-2019和SLICC-2012分类标准与临床诊断相结合可能更有助于SLE的早期诊断,并指导治疗。
Objective To compare the classification criteria for systemic lupus erythematosus(SLE)by the European League Against Rheumatism/American College of Rheumatology-2019(EULAR/ACR-2019),the International Cooperative Clinical Organization-2012(SLICC-2012)and the American College of Rheumatology-1997(ACR-1997)and evaluate the diagnostic values of the three classification criteria in combination with practical diagnosis of clinical cases.Methods A total of 73 cases diagnosed with SLE in the Affiliated Hospital of Guizhou Medical University from January 2014 to December 2019 were enrolled as the SLE goup,and another group of 82 cases diagnosed with other connective histdiseases were assigned as the control group.The data from various clinical indicators and immunological indicators were collected and analyzed in terms of the differences in sensitivity,specificity and area under ROC curve between the three SLE classification criteria.Results There were significant differences in the sensitivity and specificity between EULAR/ACR-2019,SLICC-2012 and ACR-1997,respectively(95.89%vs.98.63%vs.73.97%;92.68%vs.84.15%vs.98.78%).The sensitivity of ACR-1997 was the lowest,and the specificity of SLICC-2012 was the lowest(P<0.001).There were significant differences in missed diagnosis rate and misdiagnosis rate between EULAR/ACR-2019,SLICC-2012 and ACR-1997,ACR-1997 having the highest missed diagnosis rate and the lowest misdiagnosis rate(P<0.05).The areas under the ROC curve(AUC)of EULAR/ACR-2019,SLICC-2012,and ACR-1997 were 0.943,0.914 and 0.864,respectively,with statistically significant differnces between them(P=0.0044),but the AUC was not significant between SLICC-2012 and EULAR/ACR-2019,ACR-1997(P>0.005).Conclusion The SLE diagnostic value of EULAR/ACR-2019 is better than ACR-1997 and SLICC-2012 has no significant advantage over EULAR/ACR-2019 and ACR-1997.The combination of EULAR/ACR-19 with SLICC-12 may be more advantegeous in the early diagnosis of SLE and the direction for its treatment.
作者
林超群
王海洪
沙璐莹
王妍清
黄红莲
申婕
宋居艳
申小平
LIN Chaoqun;WANG Haihong;SHA Luying;WANG Yanqing;HUANG Honglian;SHEN Jie;SONG Juyan;SHEN Xiaoping(Department of Dermatology,Guiyang First People’s Hospital,Guiyang 550000,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2022年第1期96-100,共5页
The Journal of Practical Medicine
关键词
系统性红斑狼疮
分类标准
比较研究
早期诊断
systemic lupus erythematosus
classification criteria
comparative study
early diagnosis
