在西班牙队列中对2023年ACR/EULAR抗脂综合征分类标准的评估
Rodrigo Cantera Estefanía1, Rafael Gálvez Sánchez2, María Abando Casuso3
1Division of Hematology, Hospital Universitario de Navarra, Pamplona, Spain.
Clinical chemistry and laboratory medicine
|July 11, 2025
概括
2023年ACR/EULAR对抗脂综合征 (APS) 的标准显示高特异性但低敏感性,排除了许多患者. 这影响了临床试验在不同人群中的适用性和适用性,特别是那些患有产科APS或IgM aPL的人群.
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:
- 抗脂综合征 (APS) 的分类对于诊断和管理至关重要.
- 美国风湿病学会 (ACR) /欧洲风湿病学协会联盟 (EULAR) 的2023年标准是为了完善APS分类而开发的.
- 对这些新标准与现有标准进行验证是必不可少的.
研究的目的:
- 为了验证2023年ACR/EULAR对APS的分类标准.
- 将根据新标准分类的患者之间的临床和实验室特征与旧标准进行比较.
- 评估2023年ACR/EULAR标准对患者分类的影响,并确定导致分类解除的因素.
主要方法:
- 在高等推中心进行回顾性队列研究.
- 包括阳性狼抗凝剂 (LA),抗心素 (aCL) 或抗β2糖蛋白I (anti-β2GPI) 抗体检测的患者.
- 使用2006年悉尼标准和2023年ACR/EULAR标准对患者进行分类.
主要成果:
- 只有40.6%的符合悉尼标准的患者也符合2023年ACR/EULAR标准.
- 2023年ACR/EULAR标准显示高特异性 (97.7%),但敏感性低 (30.2%).
- 解密通常是由于排除了特定的血栓事件和重复的妊娠流产;孤立的IgM aPL阳性也是一个显著的排除因素.
结论:
- 2023年ACR/EULAR标准提高了特异性,但大大降低了APS分类的敏感性.
- 相当数量的APS患者,特别是那些患有产科APS或IgM aPL的患者,可能会被新标准排除在外.
- 对于2023年ACR/EULAR标准在不同患者群体中的临床试验资格和现实应用性存在担忧.
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