MS‑Score和HScore诊断成人Still病合并巨噬细胞活化综合征的时效性评估  

Assessment of MS‑Score and HScore in timeliness of diagnosis of macrophage activation syndrome associated with adult‑onset Still′s disease

作　　者：彭昭 高学敏 周爽 吴婵媛 赵久良 徐东 李梦涛 彭劲民 李剑[3] 王迁 田新平 曾小峰 Peng Zhao;Gao Xuemin;Zhou Shuang;Wu Chanyuan;Zhao Jiuliang;Xu Dong;Li Mengtao;Peng Jinmin;Li Jian;Wang Qian;Tian Xinping;Zeng Xiaofeng(Department of Rheumatology and Clinical Immunology,Chinese Academy of Medical Sciences&Peking Union Medical College,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC‑DID),Ministry of Science&Technology,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital(PUMCH),Key Laboratory of Rheumatology and Clinical Immunology,Ministry of Education,Beijing 100730,China;Department of Medical ICU,Chinese Academy of Medical Sciences&Peking Union Medical College,Peking Union Medical College Hospital(PUMCH),Beijing 100730,China;Department of Hematology,Chinese Academy of Medical Sciences&Peking Union Medical College,Peking Union Medical College Hospital(PUMCH),Beijing 100730,China)

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国家皮肤与免疫疾病临床医学研究中心疑难重症及罕见病国家重点实验室风湿免疫病学教育部重点实验室,北京100730 [2]中国医学科学院北京协和医学院北京协和医院内科重症监护病房,北京100730 [3]中国医学科学院北京协和医学院北京协和医院血液内科,北京100730

出　　处：《中华医学杂志》2022年第28期2210-2214,共5页National Medical Journal of China

基　　金：2021国家重点研发计划精准医学专项(2021YFC2501301‑5);中国医学科学院医学与健康科技创新工程(2021‑I2M‑1‑005);首都临床诊疗技术研究及示范应用协同创新重点项目(Z201100005520025)。

摘　　要：收集2013年1月至2020年12月在北京协和医院出院诊断为成人Still病(AOSD)合并巨噬细胞活化综合征(MAS)的33例患者的临床资料,分析比较分别应用噬血细胞性淋巴组织细胞增多症(HLH)‑2004标准、巨噬细胞活化综合征/幼年特发性关节炎评分(MS‑Score)和HLH诊断评分(HScore)确诊MAS的时间。结果发现,应用MS‑Score确诊MAS的时间[M(Q_(1),Q_(3))]比HLH‑2004标准提前19.0(4.5,31.0)d,比HScore提前13.5(0.5,21.5)d(均P<0.05);应用HScore确诊MAS的时间与应用HLH‑2004标准差异无统计学意义(P>0.05);三种诊断标准相比,诊断时间差异有统计学意义(P<0.001)。与HLH‑2004标准相比,MS‑Score能更早期诊断AOSD合并MAS,而HScore的诊断获益尚未明确。The data of 33 patients with adult‑onset still′s disease(AOSD)‑associated macrophage activation syndrome(MAS)were retrospectively collected from January 2013 to December 2020 in Peking Union Medical College Hospital.Hemophagocytic lymphohistiocytosis(HLH)‑2004 criteria,macrophage activation syndrome/juvenile idiopathic arthritis(MS‑Score)and hemophagocytic syndrome diagnostic score(HScore)were used to diagnose AOSD‑associated MAS,respectively.The time of diagnosis of AOSD‑associated MAS by MS‑Score was 19.0(4.5,31.0)days[M(Q_(1),Q_(3))]earlier than by HLH‑2004 criteria,and 13.5(0.5,21.5)days earlier than by HScore(both P<0.05).The difference was not statistically significant between the time of diagnosis of AOSD‑associated MAS by Hscore and by HLH‑2004 criteria(P>0.05).There was significant difference among the three criteria(P<0.001).MS‑Score can be used to diagnose AOSD‑associated MAS earlier than HLH‑2004 criteria,while the timeliness of HScore is not certain.

关 键 词：Still病 成年型 巨噬细胞活化综合征 噬血细胞综合征 诊断 横断面研究 

分 类 号：R593.2[医药卫生—内科学]