The Assessment of SpondyloArthritis international Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general
The Assessment of SpondyloArthritis international Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general
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DOI：
10.1136/ard.2010.133645
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发表时间：
2011-01-01
影响因子：
27.4
通讯作者：
Sieper, J.
中科院分区：
文献类型：
--
作者：
Rudwaleit, M.;van der Heijde, D.;Sieper, J.
目的 评估仅具有外周表现的 SpA 患者的外周脊柱关节炎 (SpA) 新分类标准。 方法 在国际脊柱关节炎评估协会 (ASAS) 评估研究中，将两组预先指定的标准与欧洲脊柱关节病研究组 (ESSG) 和 Amor 标准进行比较，这些患者通常在之前开始转诊，患有未确诊的外周关节炎和/或附着点炎和/或指趾炎。 45岁。以ASAS风湿病专家做出的临床诊断（SpA与无SpA）作为参考标准。结果 24个ASAS中心共纳入266名患者，最终诊断为SpA的率为66.2%。调整后，最终一组标准显示敏感性（77.8％）和特异性（82.9％）之间的最佳平衡：关节炎和/或附着点炎和/或指趾炎加上（A）一个或多个以下参数：银屑病，炎症性肠病，既往感染，人类白细胞抗原B27，葡萄膜炎，成像上的骶髂关节炎，或（B）两个或多个其他参数：关节炎，附着点炎，指趾炎，既往有炎症性背痛，SpA 家族史。新标准的表现优于 ESSG 的修改版本（敏感性 62.5%，特异性 81.1%）和 Amor 标准（敏感性 39.8%，特异性 97.8%），特别是在敏感性方面。在 975 名患者的整个 ASAS 人群中，联合使用中轴型 SpA 的 ASAS 标准和外周型 SpA 的 ASAS 标准也分别比改良的 ESSG（敏感性 79.1%，特异性 68.8%）和 Amor 标准（敏感性 67.5%，特异性 86.7%）具有更好的平衡性（敏感性 79.5%，特异性 83.3%）。 结论 新的 ASAS 分类外周 SpA 的标准在患有外周关节炎、附着点炎和/或指趾炎的患者中表现良好。
Objective To evaluate new classification criteria for peripheral spondyloarthritis (SpA) in patients with SpA with peripheral manifestations only.Methods In this Assessment of SpondyloArthritis international Society (ASAS) study, two prespecified sets of criteria were compared against the European Spondylarthropathy Study Group (ESSG) and Amor criteria in newly referred consecutive patients with undiagnosed peripheral arthritis, and/or enthesitis, and/or dactylitis that usually began before 45 years of age. The clinical diagnosis (SpA vs no SpA) made by the ASAS rheumatologist served as reference standard.Results In all, 24 ASAS centres included 266 patients, with a final diagnosis of SpA being made in 66.2%. After adjustments a final set of criteria showed the best balance between sensitivity (77.8%) and specificity (82.9%): arthritis and/or enthesitis and/or dactylitis plus (A) one or more of the following parameters: psoriasis, inflammatory bowel disease, preceding infection, human leucocyte antigen B27, uveitis, sacroiliitis on imaging, or (B) two or more other parameters: arthritis, enthesitis, dactylitis, inflammatory back pain in the past, family history of SpA. The new criteria performed better than modified versions of the ESSG (sensitivity 62.5%, specificity 81.1%) and the Amor criteria (sensitivity 39.8%, specificity 97.8%), particularly regarding sensitivity. In the entire ASAS population of 975 patients the combined use of ASAS criteria for axial SpA and ASAS criteria for peripheral SpA also had a better balance (sensitivity 79.5%, specificity 83.3%) than the modified ESSG (sensitivity 79.1%, specificity 68.8%) and Amor criteria (sensitivity 67.5%, specificity 86.7%), respectively.Conclusions The new ASAS classification criteria for peripheral SpA performed well in patients presenting with peripheral arthritis, enthesitis and/or dactylitis.