超声能够替代干燥综合征ACR三个分类标准项中的任何一个
发表者：张舸
日期：2015-02-27
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摘要：目的：本研究评估超声（US）作为附加项目在ACR 干燥综合征分类中的作用。
方法：581名患者根据美国-欧洲共识专家意见 (AECG)的分类意见中的最低要求分为干燥综合征（SS）组 (n = 364)或者非干燥综合征组 (n = 217) 。184名患者根据ACR标准得分2项或者以上阳性以及2项或者以上阴性结果分为102例干燥综合征组和82例非干燥综合征组。美国-欧洲共识专家意见作为金标准。 腮腺和/或者下颌下腺评分≥G1作为干燥综合征阳性。我们评估了超声单独或者联合ACR分类项目进行不同组合来诊断干燥综合征。
结果：ACR标准诊断184名患者，敏感性为91% ，特异性为90% ，准确性为91%。单独应用超声诊断184 ACR 患者的敏感性为79% ，特异性为90%，准确性为83%。这与AECG队列超声诊断的结果具有可比性(分别为81%, 86% 和83%)。将超声联合ACR三个分类标准项目后同ACR原始分类比较后得到89 -91% 的敏感性, 87-96%的特异性和89%或者92%的准确性。此外kappa分析指出原始ACR分类和超声替代的ACT分类结果能够完美配对 (κ=0.960-0.974).
结论：结果表明，超声能够替代ACR三个分类标准项中的任何一个。
附原文：OBJECTIVE:In this study we evaluated US as an additional classification item in the ACR classification of SS.METHODS:Of 581 patients classified as either SS (n = 364) or non-SS (n = 217) based on the minimum requirements of the American-European Consensus Group (AECG) classification, 184 patients (102 SS and 82 non-SS) who had scored two or more positive or two or more negative results according to the ACR criteria were selected. The AECG classification was used as the gold standard. A parotid and/or submandibular gland that was assigned a score ≥G1 was designated as SS positive. We evaluated US alone or with varying combinations of the ACR classification items in the diagnosis of SS.RESULTS:The ACR criteria diagnosed the 184 patients with 91% sensitivity, 90% specificity and 91% accuracy. US alone diagnosed the 184 ACR patients with 79% sensitivity, 90% specificity and 83% accuracy, which was comparable to the results of US diagnosis in the AECG cohort (81%, 86% and 83%, respectively). Incorporating the US criteria as an alternative to one of the three ACR classification items achieved 89-91% sensitivity, 87-96% specificity and 89% or 92% accuracy, which was comparable to that of the original ACR classification. Furthermore, kappa analysis indicated that the results of the original ACR and US-replaced ACR classifications matched completely (κ = 0.960-0.974).CONCLUSION:These results suggest that US can be used as an alternative to any of the three ACR classification items.
引自：Yukinori Takagi, Misa Sumi, Hideki Nakamura，et al. Ultrasonography as an additional item in the American College of Rheumatology classification of Sjögren's syndrome. Rheumatology 2014;53:1977-1983 （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）
方法：581名患者根据美国-欧洲共识专家意见 (AECG)的分类意见中的最低要求分为干燥综合征（SS）组 (n = 364)或者非干燥综合征组 (n = 217) 。184名患者根据ACR标准得分2项或者以上阳性以及2项或者以上阴性结果分为102例干燥综合征组和82例非干燥综合征组。美国-欧洲共识专家意见作为金标准。 腮腺和/或者下颌下腺评分≥G1作为干燥综合征阳性。我们评估了超声单独或者联合ACR分类项目进行不同组合来诊断干燥综合征。
结果：ACR标准诊断184名患者，敏感性为91% ，特异性为90% ，准确性为91%。单独应用超声诊断184 ACR 患者的敏感性为79% ，特异性为90%，准确性为83%。这与AECG队列超声诊断的结果具有可比性(分别为81%, 86% 和83%)。将超声联合ACR三个分类标准项目后同ACR原始分类比较后得到89 -91% 的敏感性, 87-96%的特异性和89%或者92%的准确性。此外kappa分析指出原始ACR分类和超声替代的ACT分类结果能够完美配对 (κ=0.960-0.974).
结论：结果表明，超声能够替代ACR三个分类标准项中的任何一个。
附原文：OBJECTIVE:In this study we evaluated US as an additional classification item in the ACR classification of SS.METHODS:Of 581 patients classified as either SS (n = 364) or non-SS (n = 217) based on the minimum requirements of the American-European Consensus Group (AECG) classification, 184 patients (102 SS and 82 non-SS) who had scored two or more positive or two or more negative results according to the ACR criteria were selected. The AECG classification was used as the gold standard. A parotid and/or submandibular gland that was assigned a score ≥G1 was designated as SS positive. We evaluated US alone or with varying combinations of the ACR classification items in the diagnosis of SS.RESULTS:The ACR criteria diagnosed the 184 patients with 91% sensitivity, 90% specificity and 91% accuracy. US alone diagnosed the 184 ACR patients with 79% sensitivity, 90% specificity and 83% accuracy, which was comparable to the results of US diagnosis in the AECG cohort (81%, 86% and 83%, respectively). Incorporating the US criteria as an alternative to one of the three ACR classification items achieved 89-91% sensitivity, 87-96% specificity and 89% or 92% accuracy, which was comparable to that of the original ACR classification. Furthermore, kappa analysis indicated that the results of the original ACR and US-replaced ACR classifications matched completely (κ = 0.960-0.974).CONCLUSION:These results suggest that US can be used as an alternative to any of the three ACR classification items.
引自：Yukinori Takagi, Misa Sumi, Hideki Nakamura，et al. Ultrasonography as an additional item in the American College of Rheumatology classification of Sjögren's syndrome. Rheumatology 2014;53:1977-1983 （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）