SLICC分类标准可提高诊断……

SLICC分类标准可提高诊断狼疮的敏感性

作者： Bortoluzzi A，et al.
翻译：北医三院曾冉冉（zengranran1989@163.com）
摘要：目的：本研究的目的是分析在一个大型的未分化结缔组织病(UCTD)起病并随访15年的大型患者列队中分析2012年系统性红斑狼疮国际协作组(SLICC)系统性红斑狼疮(SLE)的分类诊断标准的诊断效能，及根据1997年ACR和2012年SLICC分类标准评价UCTD向SLE的转换。方法：对满足Mosca等提出的UCTD分类诊断标准的患者人群进行分析，用2012年SLICC SLE分类诊断标准回顾性诊断初诊时（T0）和定期随访的患者，并与1997年ACR分类标准进行对比。结果：共纳入329名患者。根据入选标准在T0时间点没有患者符合SLE/ACR分类标准，同时，回顾应用SLE/SLICC标准,有44名患者已经满足SLE诊断。在随访期间，有23名新患者达到了SLE/SLICC分类诊断标准，有14名患者随着时间推移以稳定的速度逐渐进展成为SLE。急性或亚急性皮损，抗磷脂抗体阳性以及浆膜炎随SLE进展变化。结论：在UCTD人群中，疾病初发时应用SLICC SLE分类标准可以识别出一部分可能漏诊的SLE患者；在随访中，ACR标准相比较，SLCC标准扩大了诊断SLE的数量，而这部分患者应用其他标准可能被诊断为UCTD。

附原文： Abstract OBJECTIVES: The objectives of this study were to analyse the performance of the Systemic Lupus International Collaborating Clinics (SLICC) 2012 classification criteria for systemic lupus erythematosus (SLE) in a large cohort of undifferentiated connective tissue disease (UCTD) population at onset of the disease and during a long-term follow-up of 15 years (1999-2013) and to evaluate the transition from UCTD to SLE, according to American College of Rheumatology (ACR) 1997 and SLICC 2012 classification criteria.METHODS:A cohort of patients who met the classification criteria proposed by Mosca et al. for UCTD, were analysed. The SLICC 2012 classification criteria for SLE were retrospectively applied to each patient at the time of the diagnosis (T0) and also periodically re-applied and compared to ACR 1997 criteria at three different time points in the follow-up.RESULTS:329 patients were enrolled. According to inclusion criteria at T0 no patient met the SLE/ACR criteria, whilst, retrospectively applying the SLE/SLICC criteria, 44 patients already satisfied this set of criteria for SLE. During the follow-up 23 new patients reached the SLE/SLICC criteria and 14 patients met the ACR criteria with a stable rate of progression to SLE over time. Acute or subacute skin rash, antiphospholipid antibody (aPL) positivity and serositis were the variables correlated to the evolution to SLE.CONCLUSIONS:In our UCTD population, the application of SLICC classification criteria for SLE at disease onset allowed identification of a proportion of otherwise missed SLE cases; during follow-up, and compared with ACR criteria, SLICC criteria expanded the number of patients classifiable as SLE otherwise classified as UCTD.

引自：Bortoluzzi A1, Furini F2, Campanaro F2,et al. Application of SLICC classification criteria in undifferentiated connective tissue disease and evolution in systemic lupus erythematosus: analysis of a large monocentric cohort with a long-term follow-up. Lupus. 2016 Oct 4. pii: 0961203316671814. [Epub ahead of print]