THE EUROPEAN-SPONDYLARTHROPATHY-STUDY-GROUP PRELIMINARY CRITERIA FOR THE CLASSIFICATION OF SPONDYLARTHROPATHY
THE EUROPEAN-SPONDYLARTHROPATHY-STUDY-GROUP PRELIMINARY CRITERIA FOR THE CLASSIFICATION OF SPONDYLARTHROPATHY
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DOI：
10.1002/art.1780341003
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发表时间：
1991-10-01
影响因子：
--
通讯作者：
ZEIDLER, H
中科院分区：
文献类型：
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作者：
DOUGADOS, M;VANDERLINDEN, S;ZEIDLER, H
属于脊椎关节病组的大多数疾病的分类标准已经存在。 然而，脊柱关节病的范围比这些疾病的总和更广泛。 由于现有标准的不足，血清阴性的少关节炎、指关节炎或下肢多关节炎、附着点炎引起的足跟痛和其他未分化的脊柱关节病病例在流行病学研究中被忽略。 为了确定包括未分化脊柱关节病患者的分类标准，我们研究了403例所有形式的脊柱关节病患者和674例其他风湿性疾病的对照患者。 诊断是基于当地临床专家的意见。 403例患者包括168例强直性脊柱炎，68例银屑病关节炎，41例反应性关节炎，17例炎症性肠病和关节炎，109例未分类的脊柱关节病。 基于统计分析和临床推理，我们提出以下脊柱关节病的分类标准：炎性脊柱疼痛或滑膜炎（不对称或主要在下肢），以及至少以下之一：阳性家族史，银屑病，炎症性肠病，尿道炎，或急性腹泻，交替性坐骨神经痛，末端病，或骨盆区X线检查确定的骶髂关节炎。 这些标准的敏感性为87%，特异性为87%。 拟定的分类标准易于在临床实践中应用，在所有7家参与中心中均表现良好。 然而，在其他环境中对其进行进一步评估之前，我们认为这些建议是初步的。
Classification criteria for most of the disorders belonging to the spondylarthropathy group already exist. However, the spectrum of spondylarthropathy is wider than the sum of these disorders suggests. Sero-negative oligoarthritis, dactylitis or polyarthritis of the lower extremities, heel pain due to enthesitis, and other undifferentiated cases of spondylarthropathy have been ignored in epidemiologic studies because of the inadequacy of existing criteria. In order to define classification criteria that also encompass patients with undifferentiated spondylarthropathy, we studied 403 patients with all forms of spondylarthropathy and 674 control patients with other rheumatic diseases. The diagnoses were based on the local clinical expert's opinion. The 403 patients included 168 with ankylosing spondylitis, 68 with psoriatic arthritis, 41 with reactive arthritis, 17 with inflammatory bowel disease and arthritis, and 109 with unclassified spondylarthropathy. Based on statistical analysis and clinical reasoning, we propose the following classification criteria for spondylarthropathy: inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs), together with at least 1 of the following: positive family history, psoriasis, inflammatory bowel disease, urethritis, or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region. These criteria resulted in a sensitivity of 87% and a specificity of 87%. The proposed classification criteria are easy to apply in clinical practice and performed well in all 7 participating centers. However, we regard them as preliminary until they have been further evaluated in other settings.