5种ANCA相关性血管炎活动性评分量表的比较  

Comparison of Five Different Disease Activity Scoring Scales for ANCA-associated Vasculitis

作　　者：张立民[1] 吴庆军[1] 冯胜[1] 曾小峰[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院风湿免疫科

出　　处：《首都医科大学学报》2010年第1期103-105,共3页Journal of Capital Medical University

摘　　要：目的比较5种系统性血管炎活动性评分量表的可靠性及相关性,以指导临床应用。方法以45例抗中性粒细胞胞浆抗体(anti-neutrophil cytoplasmic autoantibody,ANCA)相关性血管炎(ANCA-associated vasculitis,AAV)患者为研究对象,其中包括韦格纳肉芽肿(wegener’s granulomatosis,WG)患者30例和显微镜下多血管炎(microscopic polyangitis,MPA)患者15例。由2名评测者分别根据下述5种目前国际上常用的活动指数评价量表进行计分:伯明翰血管炎活动性评分(the Birmingham VasculitisActivity Score,BVAS1994),韦格纳肉芽肿专用的BVAS(the BVAS for Wegener granulomatosis,BVAS/WG),BVAS2003,疾病累及范围指数(the Disease Extent Index,DEI),5因子评分(the Five Factor Score,FFS)。结果5种评分量表均有很高的重复信度(ICC0.97～0.98)和评测者间信度(ICC 0.93～0.98)。BVAS1994与BVAS2003(rs=0.961)、BVAS/WG(rs=0.872)、及DEI(rs=0.818),BVAS2003与BVAS/WG(rs=0.872)、DEI(rs=0.826),BVAS/WG与DEI(rs=0.776)间有较高的相关性,P值均小于0.001。FFS与其他评分量表之间无相关性。结论目前AAV活动性评分量表是可靠、有效的。应用不同评分量表所得数据之间可以相互比较。Objective Several different scales were devised to assess disease activity in anti-neutrophil cytoplasmic autoantibody（ANCA）-associated vasculitis（AAV）. To investigate the reliability and correlation of these instruments, five disease activity scales were compared. Methods Totally 45 cases of AAV including 30 Wegener granulomatosis and 15 microscopic polyangitis were scored using the five disease assessment scales： the Birmingham Vasculitis Activity Score（BVAS1994）, the BVAS for Wegener granulomatosis（BVAS/WG）, BVAS2003, the Disease Extent Index（DEI） and the Five Factor Score（FFS）. Twenty cases were rescored by the raters. All data were analyzed by SPSS statistical software. Results Reliability of the scales was high（intraclass correlations for each measure range=0.93 to 0.98）.Test/retest reliability was also high for each scale（range=0.97 to 0.98）. The scores by different activity assessing scales correlated significantly well, BVAS1994 and BVAS2003（rs=0.96, P〈0.001）, BVAS1994 and BVAS/WG（rs=0.87, P〈0.001）, BVAS1994 and DEI（rs=0.82, P〈0.001）, BVAS2003 and BVAS/WG（rs=0.87, P〈0.001）, BVAS2003 and DEI（rs=0.83, P〈0.001）, BVAS/WG and DEI（rs=0.78, P〈0.001）. Conclusion The scales for measuring disease activity in AAV are highly correlated and reliable. The different trial data could be compared with one another.

关 键 词：血管炎 抗中性粒细胞胞浆抗体 活动指数 

分 类 号：R593.27[医药卫生—内科学]