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EULAR/ACR系统性红斑狼疮分类标准解读
杨航,刘毅
0
(四川大学华西医院风湿免疫科)
摘要:
【摘要】欧洲抗风湿病联盟(EULAR)和美国风湿病学会(ACR)近日在风湿病年鉴(Ann Rheum Dis)和风湿病与关节炎(Arthritis Rheumatol)杂志上正式发布了最新的系统性红斑狼疮(SLE)分类标准。该标准于2017年提出后经过为期2年的临床验证显示了较高敏感性和特异性。相较于1997年ACR标准和2012年系统性红斑狼疮国际临床协助组(SLICC)分类标准,新标准运用了更加严谨的方法学,实现了基于专家意见和数据驱动方法的有机统一。新标准将抗核抗体(ANA)阳性作为“入围”标准,将各系统/脏器受累的临床表现及多项免疫学指标异常作为附加标准,并根据其与SLE的相关性设置不同权重进行评分,充分体现了近年来风湿病学界对SLE的进一步认识,为更好地开展科学研究提供了基础。本文就2019年EULAR/ACR分类标准的若干亮点进行简要解读,旨在强调正确认识和使用新标准,以期更早、更准确地进行分类诊断并指导治疗。
关键词:  欧洲抗风湿病联盟  美国风湿病学会  系统性红斑狼疮  分类标准
DOI:
基金项目:国家重点研发计划―精准医学研究专项(2016YFC0906201);四川大学华西医院学科卓越发展1.3.5工程项目(ZYGD18015)
Interpretation of the classification standard of Euler/ACR systemic lupus erythematosus in 2019
YANG Hang,LIU Yi
(Department of Rheumatology and Immunology, West China Hospital, Sichuan University)
Abstract:
【Abstract】Recently, the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) officially issued new classification criteria for systemic lupus erythematosus (SLE) in the journals of Annals of the Rheumatic Diseases and ARTHRITIS & RHEUMATOLOGY. The new classification criteria were introduced in 2017, and its 2year clinical validation showed excellent sensitivity and specificity. Compared to the 1997 ACR criteria and the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, the new classification criteria uphold rigorous methodology to maintain a balanced use of both expertbased and datadriven methods. The new classification criteria have defined positive antinuclear antibody (ANA) as required entry criterion, and the clinical manifestations of various systems/organs and multiple immunological abnormalities as additive criteria. The differential weighting of criteria better represents their relative contribution to SLE. The new classification criteria reflect current understanding about SLE and provide an improved foundation for SLE research. This article provides a brief review of several highlights of the 2019 EULAR/ACR classification criteria for SLE, to emphasize the correct understanding of the criteria to diagnose this heterogeneous disease earlier and more accurately.
Key words:  European League Against Rheumatism  American College of Rheumatology  Systemic lupus erythematosus  Classification criteria

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