唾液腺超声能使2012 ACR干燥综合症分类标准的诊断性能显著提高
发表者： 杨麟
日期：2015-02-27
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摘要：目的：本研究的目的是评估唾液腺超声（sGUS）是否能提高干燥综合症2012 ACR分类标准。
方法：本研究共纳入了法国的101名可疑的干燥综合症患者。超声结构分数大于等于2分被认为是反常的。诊断的参考标准是由一组医学专家根据结果双盲分析得到并进行评判。
结果：45例患者被诊断为干燥综合症。在101名可疑患者中，干燥综合症患者和非干燥综合症患者眼部染色分数>3的比率是相近的。在血清学检查方面，抗SSA / SSB抗体阳性再加上RF阳性以及ANA滴度>1:320相比于单纯的抗SSA / SSB阳性能更好增加诊断的敏感性。唾液腺超声对于诊断干燥综合症的敏感性为60%，特异性为87.5%，并且使ACR标准的敏感性增加从64.4%增加到到84.4%，而特异性仅略有下降，从91.1%到89.3%。
结论： 唾液腺超声能使干燥综合症的ACR分类标准的诊断性显著提高。唾液腺超声应包括在未来的干燥综合症诊断标准中。
附原文：Abstract Objective. The aim of this study was to evaluate whether salivary gland ultrasonography (SGUS) improves the diagnostic performance of the 2012 ACR classification criteria for SS. Methods. We studied a cohort of 101 patients with suspected SS seen at a single center in Brittany, France. An SGUS echo structure score >2 was considered abnormal. The reference standard was a clinical diagnosis of SS made by a group of experts blinded to SGUS findings. Results. SS was diagnosed in 45 patients. Similar proportions of patients with and without SS had an ocular staining score >3. Adding RF positivity and ANA titre >1:320 as an alternative to anti-SSA/SSB positivity increased the sensitivity of the serological item without modifying specificity compared with using anti-SSA/SSB alone. SGUS was 60.0% sensitive and 87.5% specific for SS. Adding the SGUS score to the ACR criteria increased sensitivity from 64.4% to 84.4% and only slightly decreased specificity, from 91.1% to 89.3%. Conclusion. The diagnostic performance of the ACR classification criteria for SS is notably improved by adding the SGUS score. SGUS should be included in future classification criteria for SS.
引自：Cornec D1, Jousse-Joulin S, Marhadour T, Pers JO, Boisramé-Gastrin S, Renaudineau Y, Saraux A, Devauchelle-Pensec V. Salivary gland ultrasonography improves the diagnostic performance of the 2012 American College ofRheumatology classification criteria for Sjogren's syndrome. Rheumatology (Oxford). 2014 Apr 4. [Epub ahead of print] （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：本研究共纳入了法国的101名可疑的干燥综合症患者。超声结构分数大于等于2分被认为是反常的。诊断的参考标准是由一组医学专家根据结果双盲分析得到并进行评判。
结果：45例患者被诊断为干燥综合症。在101名可疑患者中，干燥综合症患者和非干燥综合症患者眼部染色分数>3的比率是相近的。在血清学检查方面，抗SSA / SSB抗体阳性再加上RF阳性以及ANA滴度>1:320相比于单纯的抗SSA / SSB阳性能更好增加诊断的敏感性。唾液腺超声对于诊断干燥综合症的敏感性为60%，特异性为87.5%，并且使ACR标准的敏感性增加从64.4%增加到到84.4%，而特异性仅略有下降，从91.1%到89.3%。
结论： 唾液腺超声能使干燥综合症的ACR分类标准的诊断性显著提高。唾液腺超声应包括在未来的干燥综合症诊断标准中。
附原文：Abstract Objective. The aim of this study was to evaluate whether salivary gland ultrasonography (SGUS) improves the diagnostic performance of the 2012 ACR classification criteria for SS. Methods. We studied a cohort of 101 patients with suspected SS seen at a single center in Brittany, France. An SGUS echo structure score >2 was considered abnormal. The reference standard was a clinical diagnosis of SS made by a group of experts blinded to SGUS findings. Results. SS was diagnosed in 45 patients. Similar proportions of patients with and without SS had an ocular staining score >3. Adding RF positivity and ANA titre >1:320 as an alternative to anti-SSA/SSB positivity increased the sensitivity of the serological item without modifying specificity compared with using anti-SSA/SSB alone. SGUS was 60.0% sensitive and 87.5% specific for SS. Adding the SGUS score to the ACR criteria increased sensitivity from 64.4% to 84.4% and only slightly decreased specificity, from 91.1% to 89.3%. Conclusion. The diagnostic performance of the ACR classification criteria for SS is notably improved by adding the SGUS score. SGUS should be included in future classification criteria for SS.
引自：Cornec D1, Jousse-Joulin S, Marhadour T, Pers JO, Boisramé-Gastrin S, Renaudineau Y, Saraux A, Devauchelle-Pensec V. Salivary gland ultrasonography improves the diagnostic performance of the 2012 American College ofRheumatology classification criteria for Sjogren's syndrome. Rheumatology (Oxford). 2014 Apr 4. [Epub ahead of print] （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 ）