2018欧洲神经肌肉中心皮肌炎分类诊断标准的验证  

Validation of 2018 European Neuromuscular Centre classification for dermatomyositis

作　　者：张朴丽 孙超 张立宁 杨红霞 魏阳阳 彭清林[2] 王国春[2] 卢昕 ZHANG Pu-li;SUN Chao;ZHANG Li-ning(Peking University China-Japan Friendship School of Clinical Medicine,Beijing 100029,China)

机构地区：[1]北京大学中日友好临床医学院,北京100029 [2]中日友好医院风湿免疫科,北京100029

出　　处：《中日友好医院学报》2022年第3期139-143,共5页Journal of China-Japan Friendship Hospital

基　　金：北京市科委课题(Z191100006619012)。

摘　　要：目的:在中国特发性炎性肌病(IIM)患者中验证2018年欧洲神经肌肉中心制定的皮肌炎(2018ENMC-DM)标准。方法:回顾性收集2008年5月~2020年10月于中日友好医院风湿免疫科住院的IIM患者的临床资料、实验室检查及病理资料。分别按照1975年Bohan&Peter (B&P)、2017年美国风湿病学会/欧洲抗风湿病联盟(EULAR/ACR)及2018 ENMC-DM标准对DM患者进行重新诊断分类,比较各诊断标准对DM的敏感性、特异性。结果:共纳入成人IIM 1370例。其中符合2018 ENMC-DM标准、EULAR/ACR标准和1975 B&P标准诊断的DM患者分别为671例、693例和913例。3个标准诊断DM的敏感性为73%、72%和88%,特异性为91%、86%和69%。2018 ENMC-DM标准在有肌活检时诊断DM的敏感性和特异性为73%和88%,同时有肌活检和肌炎特异性抗体(MSA)时的敏感性和特异性为76%和97%。结论:本研究首次在中国DM人群中验证了2018 ENMC-DM新诊断分类标准,显示其在同时包含肌活检和MSA时诊断DM的特异性优于之前标准。Objective:To validate the 2018 European Neuromuscular Centre(ENMC)classification criteria for dermatomyositis(DM) in Chinese idiopathic inflammation myopathies(IIM)patients.Methods:Patients with IIM who admitted to our center from 2008 to 2020 were enrolled in this study.All information including clinical data,myositis specific autoantibodies(MSA)and muscle biopsy findings were retrospectively collected.All IIM patients were reassessed for the diagnosis for DM according to 2018 ENMC-DM,2017 EULAR/ACR and1975 B&P classification criteria,respectively.The sensitivity and specificity of the three criteria were analyzed on all patients selected.Results:A total of 1370 adult IIM patients were involved in this study.Among them,671,693 and 913 cases were diagnosed as DM according to 2018 ENMC-DM,2017 EULAR/ACR and 1975B&P criteria,respectively.The sensitivities of the three criteria were 73%,72% and 88%,respectively,and the specificities of them were 91%,86% and 69%,respectively.The sensitivity and specificity of 2018 ENMC-DM with muscle biopsy findings were 73% and 88%,while both with muscle biopsy findings and MSA were 76%and 97%.Conclusion:This study first verified the 2018 ENMC-DM classification criteria for DM in Chinese IIM patients and indicated that the specificity of 2018 ENMC criteria for the diagnosis of DM were the highest compared with previous criteria when both with muscle biopsy findings and MSA.

关 键 词：皮肌炎诊断标准 敏感性 特异性 肌炎特异性自身抗体 肌活检 

分 类 号：R593.26[医药卫生—内科学]