2009 slicc修改的acr系统性红斑狼疮分类标准

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1、SLICCRevisionoftheACRClassificationCriteriaforSLEPetri,Michelle,SystemicLupusInternationalCollaboratingClinic(SLICC)参考网址：1.http://acr.confex.com/acr/2009/webprogram/Paper13266.html2.http://www.blackwellpublishing.com/acrmeeting/abstract.asp?MeetingID=761&id=80525Purpose:TheACRC

2、lassificationCriteriaforSLEdatefrom1982witha1997revisionthatwasnotvalidated.Becauseofnewknowledgeofautoantibodies,neuropsychiatriclupus,theimportanceoflowcomplementandtheneedforlupusnephritistobea"standalone"criterion,theSLICCgroupundertookarevision.Method:Aninitialsetofrelevan

3、tvariableswasdetermined.Realpatientscenarios(n=716)ofSLEandnon-SLEcontrolsweresubmittedbySLICCcenters.Aconsensusdiagnosiswasarrivedatforeachscenario.TheconsensusdiagnoseswereusedtoidentifythevariablesthatweremostpredictiveofSLE.Recursivepartitioningwasemployedtoderiveaclassific

4、ationrulebasedonmultiplecandidatespredictorvariables.ThispreliminaryclassificationrulewasdiscussedatthreeSLICCmeetings,independentlyvalidatedbyaSLICCsteeringcomitteeandfurtherrefined.Results:ClassifyapatientashavingSLEif:Thepatienthasbiopsy-provenlupusnephritiswithANAoranti-dsD

5、NAORthepatientsatisfiesfourofthecriteria,includingatleastoneclinicalandoneimmunologiccriterion.ClinicalCriteria1.Acuteorsubacutecutaneouslupus2.Chroniccutaneouslupus3.Oral/Nasalulcers4.Nonscarringalopecia5.Inflammatorysynovitiswithphysician-observedswellingoftwoormorejointsORte

6、nderjointswithmorningstiffness6.Serositis7.Renal:Urineprotein/creatinine(or24hrurineprotein)representingatleast500mgofprotein/24hrorredbloodcellcasts8.Neurologic:seizures,psychosis,mononeuritismultiplex,myelitis,peripheralorcranialneuropathy,cerebritis(acuteconfusionalstate)9.H

7、emolyticanemia10.Leukopenia(<4000/mm3atleastonce)ORLymphopenia(<1000/mm3atleastonce)11.Thrombocytopenia(<100,000/mm3)atleastonceImmunologicCriteria1.ANAabovelaboratoryreferencerange2.Anti-dsDNAabovelaboratoryreferencerange(exceptELISA:twiceabovelaboratoryreferencerange)3.Anti-S

8、m4.Antiphospholipidantibodylupusanticoagulantfalse-pos