THE AMERICAN-RHEUMATISM-ASSOCIATION 1987 REVISED CRITERIA FOR THE CLASSIFICATION OF RHEUMATOID-ARTHRITIS
THE AMERICAN-RHEUMATISM-ASSOCIATION 1987 REVISED CRITERIA FOR THE CLASSIFICATION OF RHEUMATOID-ARTHRITIS
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DOI：
10.1002/art.1780310302
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发表时间：
1988-03-01
影响因子：
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通讯作者：
HUNDER, GG
中科院分区：
文献类型：
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作者：
ARNETT, FC;EDWORTHY, SM;HUNDER, GG
类风湿性关节炎 (RA) 分类的修订标准是根据对 262 名当代连续研究的 RA 患者和 262 名患有 RA 以外的风湿性疾病（非 RA）的对照受试者的计算机分析制定的。新标准如下：1）关节内及其周围的晨僵持续至少1小时才能得到最大程度的改善； 2) 医生观察到3个或更多关节区域的软组织肿胀（关节炎）； 3）近端指间关节、掌指关节或腕关节肿胀（关节炎）； 4）对称性肿胀（关节炎）； 5）类风湿结节； 6) 类风湿因子的存在； 7) 手和/或腕关节的放射线侵蚀和/或关节周围骨质减少。标准 1 至 4 必须已存在至少 6 周。类风湿性关节炎的定义是存在 4 个或更多标准，不需要进一步的资格（典型的、明确的或可能的）或排除列表。此外，还提供了一个“分类树”模式，其性能与传统（7 中的 4）格式相同。与非 RA 风湿病对照受试者相比，新标准对 RA 的敏感性为 91-94%，特异性为 89%。
The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a "classification tree" schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.