2023年ACR/EULAR对抗脂综合征的分类标准:更多的光线上升,但阴影仍然存在
Jaume Alijotas-Reig1,2,3, Francesc Miro-Mur3, Ariela Hoxha4
1Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain jaime.alijotas@uab.cat.
RMD open
|August 25, 2025
概括
2023年抗脂综合征 (APS) 分类标准将特异性优先于敏感性,可能将患者排除在必要护理之外. 这种转变影响了这种自身免疫性疾病的诊断和治疗.
科学领域:
- 关节病学
- 免疫学
- 自身免疫性疾病
背景情况:
- 抗脂综合征 (APS) 缺乏普遍接受的诊断标准,在临床环境中经常滥用先前的分类标准.
- 2006年用于研究的悉尼标准经常用于诊断,模糊了分类和临床评估之间的界限.
研究的目的:
- 评估新发布的2023年抗脂综合征 (APS) 分类标准的优点和局限性.
- 分析修订的APS分类标准的临床和研究影响,重点关注其对患者诊断和管理的影响.
主要方法:
- 美国风湿病学会 (ACR) 和欧洲风湿病学协会联盟 (EULAR) 更新的2023年APS分类标准的审查和分析.
- 审查六个新的临床和两个实验室领域,并纳入修订的标准.
- 评估新标准的特异性 (99%) 和敏感性 (84%).
主要成果:
- 2023年标准强调高特异性 (99%) 以降低灵敏度为代价 (84%).
- 新的临床特征包括血栓缺血,心脏问题和微血管血栓,扩大了潜在的患者识别.
- 许多疑似抗脂抗体相关疾病的患者可能不符合新的分类标准,可能导致治疗延迟或拒绝.
结论:
- 虽然修订后的APS分类标准提高了研究的特异性,但可能会在临床实践中无意中排除患者,从而冒着不良结果的风险.
- 标准的转变需要仔细考虑诊断与分类的作用,以确保适当的患者管理和预防血栓或产科事件.
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