2009SLICC修改的ACR系统性红斑狼疮分类标准.docVIP

SLICC Revision of the ACR Classification Criteria for SLEPetri, Michelle, Systemic Lupus International Collaborating Clinic (SLICC)参考网址：1. /acr/2009/webprogram/Paper13266.html2. /acrmeeting/abstract.asp?MeetingID=761id=80525Purpose: The ACR Classification Criteria for SLE date from 1982 with a 1997 revision that was not validated. Because of new knowledge of autoantibodies, neuropsychiatric lupus, the importance of low complement and the need for lupus nephritis to be a stand alone criterion, the SLICC group undertook a revision.Method: An initial set of relevant variables was determined. Real patient scenarios (n=716) of SLE and non-SLE controls were submitted by SLICC centers. A consensus diagnosis was arrived at for each scenario. The consensus diagnoses were used to identify the variables that were most predictive of SLE. Recursive partitioning was employed to derive a classification rule based on multiple candidates predictor variables. This preliminary classification rule was discussed at three SLICC meetings, independently validated by a SLICC steering comittee and further refined.Results: Classify a patient as having SLE if: The patient has biopsy-proven lupus nephritis with ANA or anti-dsDNA OR the patient satisfies four of the criteria, including at least one clinical and one immunologic criterion.Clinical Criteria1. Acute or subacute cutaneous lupus2. Chronic cutaneous lupus3. Oral/Nasal ulcers4. Nonscarring alopecia5. Inflammatory synovitis with physician-observed swelling of two or more joints OR tender joints with morning stiffness6. Serositis7. Renal: Urine protein/creatinine (or 24 hr urine protein) representing at least 500 mg of protein/24 hr or red blood cell casts8. Neurologic: seizures, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy, cerebritis (acute confusional state)9. Hemolytic anemia10. Leukopenia (4000/mm3 at least once)ORLymphopenia (1000/mm3 at least once)11. Thrombocytopenia (100