Classification and diagnostic criteria for psoriatic arthritis
Classification and diagnostic criteria for psoriatic arthritis
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DOI：
10.1136/ard.2004.032318
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发表时间：
2005-03-01
影响因子：
27.4
通讯作者：
Taylor, WJ
中科院分区：
文献类型：
--
作者：
Helliwell, PS;Taylor, WJ
背景：银屑病关节炎的研究是困难的，并且落后于其他关节病的研究，因为没有普遍同意或适当验证的病例定义。方法：本文考察了Moll和Wright标准及其后续标准集的有效性和实用性。本文回顾了银屑病和其他关节病的主要特征。对银屑病关节炎和类风湿关节炎患者进行比较研究，比较不同的分类方法。结果：尽管Moll和Wright标准继续被广泛使用，但它们已被证明难以区分银屑病和类风湿性关节炎。相比之下，最敏感的标准是Vasey和Espinoza， McGonagle等人和Gladman等人（99%）的标准，而其他标准的敏感性明显较低（56%至94%）。所有方法的特异性都很高，且统计学上相似（在93% ~ 99%之间）。即使没有牛皮癣或类风湿因子等关键变量，也有相当好的准确性的模型被开发出来。脊髓受累仍然是银屑病关节炎的一个关键特征，但与经典强直性脊柱炎的不同之处已被强调。结论：银屑病关节炎的分类标准有待进一步研究。一项收集银屑病和非银屑病病例的临床、放射学、人类白细胞抗原（HLA）和免疫学数据的前瞻性研究将为银屑病关节炎研究提供一致的标准。
Background: The study of psoriatic arthritis is difficult and has lagged behind the study of other arthropathies in that there are no universally agreed or properly validated case definitions.Method: This paper examined the validity and practicality of the original Moll and Wright criteria and subsequent criteria sets. Key features discriminating between psoriatic and other arthropathies were reviewed. A comparative study involving patients with psoriatic arthritis and rheumatoid arthritis was used to contrast the different classification methods.Results: Although the Moll and Wright criteria continue to be widely used, they have been shown to discriminate poorly between psoriatic and rheumatoid arthritis. In comparison, the most sensitive criteria were those of Vasey and Espinoza, McGonagle et al, and Gladman et al (99%), whereas the others were significantly less sensitive (between 56% and 94%). The specificity of all methods was high and statistically similar (between 93% and 99%). Models that had reasonably good accuracy even without such key variables as psoriasis or rheumatoid factor were developed. Spinal involvement continues to be a key feature of psoriatic arthritis, but dissimilarities with classic ankylosing spondylitis have been highlighted.Conclusions: Further work is required to produce classification, criteria for psoriatic arthritis. A prospective study collecting clinical, radiological, human leucocyte antigen (HLA) and immunological data from both psoriatic and nonpsoriatic cases should provide agreed criteria for use in psoriatic arthritis studies in the future.