2017年欧洲抗风湿病联盟/美国风湿病学会特发性炎性肌病的分类标准对中国皮肌炎患者的适用性  

Applicability of European League Against Rheumatism/American College of Rheumatology classification criteria for idiopathic inflammatory myopathies in Chinese dermatomyositis cohort

作　　者：王倩倩[1] 高聪聪 梁文芳 孙文博 狄雪琪 张纯祎 姚孟辉 郑朝晖[1] Wang Qianqian;Gao Congcong;Liang Wenfang;Sun Wenbo;Di Xueqi;Zhang Chunyi;Yao Menghui;Zheng Zhaohui(Department of Rheumatology,The First Affiliated Hospital of Zhengzhou University,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院风湿免疫科,450052

出　　处：《中华风湿病学杂志》2020年第12期836-839,共4页Chinese Journal of Rheumatology

基　　金：河南省自然科学基金(162300410273);河南省医学科技攻关计划(LHGJ20190260)。

摘　　要：目的探讨2017年EULAR/ACR提出的特发性炎性肌病的分类标准(EULAR/ACR标准)对中国DM患者的适用性,并对EULAR/ACR标准与Bohan&Peter分类标准(B/P标准)进行比较。方法收集2012年8月至2019年3月郑州大学第一附属医院出院诊断为"DM"患者资料,回顾性分析患者的临床表现和实验室检查,并按照B/P标准及EULAR/ACR标准重新进行分类诊断。结果共收集453例DM患者女性333例,男性120例,包括临床典型皮肌炎(CDM)330例和无肌病性皮肌炎(CADM)123例。B/P标准和EULAR/ACR标准诊断敏感度分别为68.7%,90.7%,2个标准的诊断一致性低(κ=0.137,P<0.01)。92.7%CDM和85.3%CADM患者经EULAR/ACR标准诊断可能性≥55%,86.9%CDM患者和19.5%的CADM患者可被B/P标准诊断。结论EULAR/ACR标准较B/P标准对中国DM患者的诊断敏感度更高,更有利于对ADM分型。Objective To assess the applicability of European League Against Rheumatism/American College of Rheumatology classification criteria(EULAR/ACR criteria)for dermatomyositis(DM)in Chinese cohort,and compare the differences of the two criteria.Methods This retrospective study evaluated the clinical data of patients with DM diagnosed by physicians of the first affiliated hospital of Zhengzhou University from August 2012 to March 2019.The Bohan&Peter criteria and EULAR/ACR criteria were used to determine the probability of classification for these patients.Results 453 patients with DM(333 men and 120 women)including 330 classic dermatomyositis(CDM)and 123 clinically amyopathic dermatomyositis(CADM)were included.The sensitivity of Bohan&Peter criteria and EULAR/ACR criteria was 68.7%,90.7%,respectively,the agreement between the two criteria was poor(κ=0.137,P<0.01).92.7%of patients with CDM and 85.3%of patients with CADM could meet the suggested 55%minimum probability cutoff to be classified based on EULAR/ACR criteria.86.9%of patients with CDM and 19.5%of patients with CADM could be diagnosed by Bohan&Peter criteria.Conclusion Compared with Bohan&Peter criteria,EULAR/ACR classification has higher sensitivity in Chinese patients with DM,and is more applicable to classify Chinese patients with ADM.

关 键 词：皮肌炎 诊断 特发性炎性肌病 

分 类 号：R593.26[医药卫生—内科学]