系统性红斑狼疮诊断标准的发展

··210016SLE。SLE1997SLE。SLE。ThediagnosiscriteriaofSLEanditsdevelopmentYANGJingLIUZhi-hongResearchInstituteofnephrologyJinlingHospitalNanjingUniversitySchoolofMedicineNanjing210016ChinaABSTRACTSystemiclupuserythematosusisacommonautoimmunediseasewithgreatvariationsinclinicalmanifestationsandimmunologicdisorders．ThediagnosisonatypicalSLEpatientsisdifficultsothecriteriafortheclassificationofSLEhavebeenrevisedformanytimes．Nowthemostcommonacceptedcriteriaarethe1997ACRrevisedcriteriabutmultiplelimitationshavebeenfoundduringapplication．TheSLICCgroupformulatedthenewSLEclassificationcriteriainordertoimproveclinicalrelevance．ThisarticlewillintroducetheprogressionofSLEclassificationcriteriainrecentyearsandtheformulationofSLEclassificationcriteriabySLICC．KeywordssystemiclupuserythematosusclassificationcriteriaSystemicLupusInternationalCollaboratingClinicsSLE。SLESLE。SLE1997AmericanCollegeofRheumatologyACR1988AmericanRheumatismAssociationARASLE。SystemicLupusInternationalCollaboratingClinicsSLICCSLE。SLE。SLE1971ARASLE2SLE、SLE。1982ARASLE3、ds-DNASm4-7。1997ACR810“”“”“”ACR。SLE。1984Clough9ClevelandSLE2002Costenbader10Boston。Sanchez·351·2222013411ACR、。1988Edworthy12SLE。11982SLE31．2．3．/4．5．≥2、6．1、2、7．1＞0．5g/24h＞+++2、、、8．1、、2、、9．12＜4×109/L23＜1．5×109/L24＜100×109/L10．12ds-DNA3Sm4611．“”11SLE21997SLE81．2．3．/4．5．≥2、6．1、2、7．1＞0．5g/24h＞+++2、、、8．1、、2、、9．12＜4×109/L23＜1．5×109/L24＜100×109/L10．1ds-DNA2Sm3IgGIgM、611．“”11SLE·451·JNephrolDialyTransplantVol．22No．2Apr．2013SLICCSLICCSLICC/ACRDI13SLE。SLICCSLE14。12706SLE、、SLE3702＞80%。7024。SLICC。3SLICCSLE*141．2．/3．、、、、34．、、、5．≥2≥230min6．＞1d＞1d、、Dressler's7．24h＞500mg/24h8．、、/、、9．10．＜4×109/LFelty's、＜1×109/L、11．＜100×109/L、1．ANA2．ds-DNAELISA＞23．Sm4．IgA、IgGIgMβ2IIgA、IgGIgM5．C3C4CH506．SLESLICC*ds-DNA·551·22220134SLICC1997ACR70294%vs86%P＜0.000192%vs93%P=0.3949vs70P=0.0082。1690SLE2615753SLICC1997ACR690KappaMcNemar's。1997ACRSLICC97%vs83%P＜0.000184%vs96%P＜0.0001Kappa0.82vs0.7962vs74P=0.24SLICC1997ACR。615SLICC98%91%ACR88%98%9。SLICCSLICC8SLICCSLE。1997ACR12SLE3430min56ACR7158ds-DNA、Sm、、、ELISAds-DNAβ2IIgA169、“”10LNISN/RPS200317ANAds-DNASLE。SLICCSLE1982ARA29SLEACRFries18。SLICC1997ACR。SLICCSLE。SLE5%SLE19。1HelmickCGFelsonDTLawrenceRCetal．EstimatesoftheprevalenceofarthritisandotherrheumaticconditionsintheUnitedStatespartI．ArthritisRheum200858115-25．2CohenASCanosoJJ．Criteriafortheclassificationofsystemiclupuserythematosus—status1972．ArthritisRheum1972155540-543．3TanEMCohenASFriesJFetal．The1982revisedcriteriafortheclassificationofsystemiclupuserythematosus．ArthritisRheum198225111271-1277．4LevinREWeinsteinAPetersonMetal．Acomparisonofthesensitivityofthe1971and1982AmericanRheumatismAssociationcriteriafortheclassificationofsystemiclupuserythematosus．ArthritisRheum1984275530-538．5PassasCMWongRLPetersonMetal．Acomparisonofthespecificityofthe1971and1982AmericanRheumatismAssociationcriteriafortheclassificationofsystemiclupuserythematosus．ArthritisRheum1985286620-623．6YokohariRTsunematusT．ApplicationtotheJapanesepatientsofthe1982AmericanRheumatismAssociationrevisedcriteriafortheclassificationofsystemiclupuserythematosus．ArthritisRheum1985·651·JNephrolDialyTransplantVol．22No．2Apr．2013286693-698．7DavatchiFChamsCAkbarianM．Evaluationofthe1982AmericanRheumatismAssociationrevisedcriteriafortheclassificationofsystemiclupuserythematosus．ArthritisRheum1985286715．8HochbergMC．UpdatingtheAmericanCollegeofRheumatologyrevisedcriteriafortheclassificationofsystemiclupuserythematosus．ArthritisRheum19974091725．9CloughJDElrazakMCalabreseLHetal．Weightedcriteriaforthediagnosisofsystemiclupuserythematosus．ArchInternMed19841442281-285．10CostenbaderKHKarlsonEWMandlLA．DefininglupuscasesforclinicalstudiestheBostenweightedcriteriafortheclassificationofsystemiclupuserythematosus．JRheumatol200229122545-2550．11EdworthySMZatarainEMcShaneDJetal．Analysisofthe1982ARAlupuscriteriadatasetbyrecursivepartitioningmethodologynewinsightstotherelativemeritofindividualcriteria．JRheumatol198815101493-1498．12SanchezMLAlarcónGSMcGwinGJretal．CantheweightedcriteriaimproveourabilitytocapturealargernumberoflupuspatientsintoobservationalandinterventionalstudiesAcomparisonwiththeAmericanCollegeofRheumatologycriteria．Lupus2003126468-470．13GladmanDGinzlerEGoldsmithCetal．ThedevelopmentandinitialvalidationoftheSystemicLupusInternationalCollaboratingClinics/AmericanCollegeofRheumatologydamageindexforsystemiclupuserythematosus．ArthritisRheum1996393363-369．14PetriMOrbaiAMAlarcónGSetal．DerivationandvalidationoftheSystemicLupusInternationalCollaboratingClinicsclassificationcriteriaforsystemiclupuserythematosus．ArthritisRheum20126482677-2686．15ReedWWDiehlLF．LeukopenianeutropeniaandreducedhemoglobinlevelsinhealthyAmericanblacks．ArchInternMed19911513501505．16MehraniTPetriM．AssociationofIgAanti-β2glycoproteinIwithclinicalandlaboratorymanifestationsofsystemiclupuserythematosus．JRheumatol201138164-68．17WeeningJJD＇AgatiVDSchwartzMMetal．Theclassificationofglomerulonephritisinsystemiclupuserythematosusrevisited．KidneyInt2004652521-530．18FriesJF．MethodologyofvalidationofcriteriaforSLE．ScandJRheumatolSu