2017年欧洲抗风湿病联盟/美国风湿病学会特发性炎性肌病的分类标准对中国皮肌炎患者的适用性

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目的:探讨2017年EULAR/ACR提出的特发性炎性肌病的分类标准(EULAR/ACR标准)对中国DM患者的适用性,并对EULAR/ACR标准与Bohan & Peter分类标准(B/P标准)进行比较。方法:收集2012年8月至2019年3月郑州大学第一附属医院出院诊断为“DM”患者资料,回顾性分析患者的临床表现和实验室检查,并按照B/P标准及EULAR/ACR标准重新进行分类诊断。结果:共收集453例DM患者女性333例,男性120例,包括临床典型皮肌炎(CDM)330例和无肌病性皮肌炎(CADM)123例。B/P标准和EULAR/ACR标准诊断敏感度分别为68.7%,90.7%,2个标准的诊断一致性低(n κ=0.137,n P<0.01)。92.7%CDM和85.3%CADM患者经EULAR/ACR标准诊断可能性≥55%,86.9%CDM患者和19.5%的CADM患者可被B/P标准诊断。n 结论:EULAR/ACR标准较B/P标准对中国DM患者的诊断敏感度更高,更有利于对ADM分型。“,”Objective:To assess the applicability of European League Against Rheumatism/American College of Rheumatology classification criteria (EULAR/ACR criteria) for dermatomyositis (DM) in Chinese cohort, and compare the differences of the two criteria.Methods:This retrospective study evaluated the clinical data of patients with DM diagnosed by physicians of the first affiliated hospital of Zhengzhou University from August 2012 to March 2019. The Bohan & Peter criteria and EULAR/ACR criteria were used to determine the probability of classification for these patients.Results:453 patients with DM (333 men and 120 women)including 330 classic dermatomyositis (CDM) and 123 clinically amyopathic dermatomyositis(CADM) were included. The sensitivity of Bohan & Peter criteria and EULAR/ACR criteria was 68.7%, 90.7%, respectively, the agreement between the two criteria was poor ( n κ=0.137, n P<0.01). 92.7% of patients with CDM and 85.3% of patients with CADM could meet the suggested 55% minimum probability cutoff to be classified based on EULAR/ACR criteria. 86.9% of patients with CDM and 19.5% of patients with CADM could be diagnosed by Bohan & Peter criteria.n Conclusion:Compared with Bohan & Peter criteria, EULAR/ACR classification has higher sensitivity in Chinese patients with DM, and is more applicable to classify Chinese patients with ADM.
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