2023年ACR/EULAR分类标准对START2抗脂注册表的影响
Anna Aiello1, Luca Sarti2, Gilda Sandri3
1Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
International journal of laboratory hematology
|December 11, 2024
概括
针对抗脂综合征 (APS) 的新ACR/EULAR标准排除了许多以前被归类为APS的患者. 这是由于实验室方法和积极的抗脂抗体 (aPL) 测试的时间不同.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 2019年ACR/EULAR对抗脂综合征 (APS) 的分类标准整合了临床和实验室发现.
- 实验室标准包括狼抗凝剂 (LA),抗心素 (aCL) 和抗β2-糖蛋白I (aß2GPI) 抗体,其点值各不相同.
- 在阳性抗脂抗体 (aPL) 测试和临床表现之间超过3年的时间间隔排除了APS诊断.
研究的目的:
- 评估START 2注册表中现有的APS诊断与新ACR/EULAR分类标准的一致性.
- 确定APS的旧分类标准和新分类标准之间的差异的原因.
主要方法:
- 来自START 2抗脂注册表的380名患者的分析 (274名APS,106名携带者).
- 将患者数据与已确定的ACR/EULAR分类标准进行比较,重点关注实验室测试方法和时间.
- 对APS患者和携带者实现诊断标准的评估.
主要成果:
- 43% (118/274) 被归类为APS的患者没有满足新的ACR/EULAR标准.
- 排除原因包括使用自动仪器进行aCL/aß2GPI测试,实验室测试得分不足 (例如,孤立的IgM aCL/aß2GPI,未经证实的LA),以及aPL阳性和临床事件之间的差距超过3年.
- 62%的运营商符合实验室标准 (aCL/aß2GPI的ELISA),但缺乏APS的临床标准.
结论:
- 根据以前的标准诊断出APS的患者中有很大一部分不符合严格的新ACR/EULAR分类标准.
- 该研究强调了实验室测试和时间关系中的方法差异对APS分类的影响.
- 在新的分类标准实施后,可能需要对APS诊断进行重新评估.
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