干燥综合症评分PPT医学课件.ppt

,干燥综合征的疾病评价,SS以淋巴细胞增殖和进行性外分泌腺体损伤为特性的系统性疾病临床特点：温和但可能影响功能的症状：干燥症状、疼痛、疲乏，见于大多患者潜在系统性表现：见于20-40%的患者核心指标：症状（sicca特点、疲乏、健康相关的生活质量）系统损害的活动性（复合的活动指标和实验室检测）,现有pSS疾病评价标准分类：,1疾病活动度评分（SSDAI、SCAI、ESSDAI）2患者主观评分(PROFAD、SICCA、ESSPRI)3疾病损伤评分（SSDDI、SSDI）,ESSPRI的产生EULARSjogrensSyndromePatientReportedIndex,2008.12.42009.11.30入组230名SS患者，来自欧洲、南北美洲12个国家21名SS专家参与EULAR的国际合作项目2011年2月研究结果online版首发发表于ARDEULARSjogrensSyndromePatientReportedIndex(ESSPRI):developmentofaconsensuspatientindexforprimarySjogrenssyndrome.AnnRheumDis.2011Jun;70(6):968-72.Epub2011Feb22.,ESSPRI的实验设计内容,4个主要症状：干燥症状、疼痛、躯体疲劳、精神疲倦。每项分值范围010分患者认为最需要改善的一项症状疲劳与不适问卷(PROFAD)Sicca症状调查表(SSI)金标准：患者整体评价（PGA）010分EULARSjogrensSyndromePatientReportedIndex(ESSPRI):developmentofaconsensuspatientindexforprimarySjogrenssyndrome.AnnRheumDis.2011Jun;70(6):968-72.Epub2011Feb22.,ESSPRI的实验结果,1.多变量回归分析证明，干燥症状、肢体痛、疲劳与PGA符合度好，但是精神疲倦与PGA符合度较差。2.患者认为最需要改善的症状：干燥症状（38.7%）、疲劳（32.2%）、肢体痛（19.6%），最不重要的为精神疲倦,3.在干燥症状中，口干、眼干被认为最重要4.ESSPRI最终评分为干燥症状、疲乏、肢体痛三个积分的平均值，范围为010分,EULARSjogrenssyndromediseaseactivityindex:developmentofaconsensussystemicdiseaseactivityindexforprimarySjogrenssyndrome.AnnRheumDis.2010Jun;69(6):1103-9.Epub2009Jun28.Erratumin:AnnRheumDis.2011May;70(5):880.,ESSPRI的特性,1.完全由患者主观填表所得，与ESSDAI良好互补2.与PGA、PROFAD、SSI符合度好（r=0.70、0.73、0.66)，用以评价患者症状的准确性较高。3.大样本、多中心4.简单易行，适用于临床EULARSjogrensSyndromePatientReportedIndex(ESSPRI):developmentofaconsensuspatientindexforprimarySjogrenssyndrome.AnnRheumDis.2011Jun;70(6):968-72.Epub2011Feb22.,PROFAD评分,MeasurementoffatigueanddiscomfortinprimarySjogrenssyndromeusinganewquestionnairetool.Rheumatology(Oxford).2004Jun;43(6):758-64.Epub2004Mar23.,SSI评分(siccasymptomsinventory),ValidationoftheSiccaSymptomsInventoryforclinicalstudiesofSjgrenssyndrome.BowmanSJ,BoothDA,PlattsRG,FieldA,RostronJ;UKSjgrensInterestGroup.JRheumatol.2003Jun;30(6):1259-66.,EULAR的疾病活动度评分标准ESSDAI,EULARSjogrenssyndromediseaseactivityindex,ESSDAI评分标准,（权重3）,（4）,（2）,(2),(3),(5),(5),(6),(5),(5),(2),(1),欧洲风湿病联盟提出新的干燥综合征疾病活动指数丁艳何菁北京大学人民医院风湿免疫科中华风湿病杂志2010第八期,接上表,ESSDAI与ESSPRI二者互补，将二者联用作为临床实验和临床工作的评价工具,EULARSjogrensSyndromePatientReportedIndex(ESSPRI):developmentofaconsensuspatientindexforprimarySjogrenssyndrome.AnnRheumDis.2011Jun;70(6):968-72.Epub2011Feb22.,EULARSjogrenssyndromediseaseactivityindex:developmentofaconsensussystemicdiseaseactivityindexforprimarySjogrenssyndrome.AnnRheumDis.2010Jun;69(6):1103-9.Epub2009Jun28.Erratumin:AnnRheumDis.2011May;70(5):880.,其它目前使用的疾病活动度评分SSDAI评分,SjgrensSyndromeDiseaseDamageIndexanddiseaseactivityindex:scoringsystemsfortheassessmentofdiseasedamageanddiseaseactivityinSjgrenssyndrome,derivedfromananalysisofacohortofItalianpatients.VitaliCetal.ArthritisRheum.(2007),SCAI评分SjgrensSystemicClinicalActivityIndex,SjgrensSystemicClinicalActivityIndex(SCAI)-asystemicdiseaseactivitymeasureforuseinclinicaltrialsinprimarySjgrenssyndrome.Rheumatology(Oxford).2007Dec;46(12):1845-51.,干燥综合征疾病损伤评分（SSDDI）,SjgrensSyndromeDiseaseDamageIndexanddiseaseactivityindex:scoringsystemsfortheassessmentofdiseasedamageanddiseaseactivityinSjgrenssyndrome,derivedfromananalysisofacohortofItalianpatients.VitaliCetal.ArthritisRheum.(2007),干燥综合征损