Clinical Diagnostic Criteria for Gout Comparsion With the Gold Standard of Synovial Fluid Crystal Analysis
Clinical Diagnostic Criteria for Gout Comparsion With the Gold Standard of Synovial Fluid Crystal Analysis
复制标题
DOI：
10.1097/rhu.0b013e3181945b79
复制
发表时间：
2009-01-01
影响因子：
3.4
通讯作者：
Clayburne, Gilda M.
中科院分区：
文献类型：
--
作者：
Malik, Aarti;Schumacher, H. Ralph;Clayburne, Gilda M.
背景：痛风的几个分类或诊断标准集已被提出，但没有得到验证。目的：这项小型初步研究将尿酸盐结晶鉴定作为诊断的金标准，并将3个建议标准集的临床方面与该标准进行比较。方法：对在退伍军人管理局医学中心进行滑液分析的82名受试者进行研究。结果：3项罗马临床标准中有2项的阳性预测值最高，为76.9%。所研究的3组标准都没有超过70%的敏感度或88.5%的特异度。ARA(ACR)初步分类标准的临床特征具有70%的敏感性和78.8%的特异性。结论：建议的各种临床标准可以为痛风的诊断或排除提供支持，但除非制定改进的标准，否则晶体鉴定仍应是金标准。
Background: Several classification or diagnostic criteria sets for gout have been proposed but none validated.Objective: This small pilot study considered urate crystal identification as the gold standard for diagnosis and compared the clinical aspects of 3 proposed criteria sets with that standard.Methods: Eighty-two subjects who had synovial fluid analyses in a VA medical center were studied. ARA (ACR), Rome, and New York clinical criteria sets and individual criteria were recorded in the 30 patients who had urate crystals versus the remainder with no urate crystals.Results: Presence of 2 of,3 Rome clinical criteria had the highest positive predictive value at 76.9%. None of the 3 studied criteria sets were more than 70% sensitive or 88.5% specific. The clinical features of the ARA (ACR) preliminary classification criteria had 70% sensitivity and 78.8% specificity.Conclusions: The various proposed clinical criteria can provide support for a diagnosis or exclusion of gout, but unless improved criteria can be developed crystal identification should remain the gold standard.