干燥综合症评分最终版.ppt

1、,干燥综合征的疾病评价 北京积水潭医院-伍沪生,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EULAR Sjogrens Syndrome Patie

2、nt Reported Index,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ARD EULAR Sjogrens Syndrome Patient Reported Index (ESSPRI):development of a consensus patient index for primary Sjogrens syndrome. Ann Rheum Dis. 2011 Jun;70(6):968-72. Epub 2011 Feb 22.,ESS

3、PRI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 EULAR Sjogrens Syndrome Patient Reported Index (ESSPRI):development of a consensus patient index for primary Sjogrens syndrome. Ann Rheum Dis. 2011 Jun;70(6):968-72. Epub 2011 Feb 22.,E

4、SSPRI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,EULAR Sjogrens syndrome disease activity index: development of a consensus systemic disease activity index for prima

5、ry Sjogrens syndrome. Ann Rheum Dis. 2010 Jun;69(6):1103-9. Epub 2009 Jun 28. Erratum in: Ann Rheum Dis. 2011 May;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 EULAR Sjogrens Syndrome Patient Reported Index (ESSPRI):dev

6、elopment of a consensus patient index for primary Sjogrens syndrome. Ann Rheum Dis. 2011 Jun;70(6):968-72. Epub 2011 Feb 22.,PROFAD评分,Measurement of fatigue and discomfort in primary Sjogrens syndrome using a new questionnaire tool. Rheumatology (Oxford). 2004 Jun;43(6):758-64. Epub 2004 Mar 23.,SSI

7、评分(sicca symptoms inventory),Validation of the Sicca Symptoms Inventory for clinical studies of Sjgrens syndrome. Bowman SJ, Booth DA, Platts RG, Field A, Rostron J; UK Sjgrens Interest Group. J Rheumatol. 2003 Jun;30(6):1259-66.,EULAR的疾病活动度评分标准ESSDAI,EULAR Sjogrens syndrome disease activity index,E

8、SSDAI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,EULAR Sjogrens Syndrome Patient Reported Index (ESSPRI):development of a consensus patient index for primary Sjogrens syndrome. Ann Rheum

9、 Dis. 2011 Jun;70(6):968-72. Epub 2011 Feb 22.,EULAR Sjogrens syndrome disease activity index: development of a consensus systemic disease activity index for primary Sjogrens syndrome. Ann Rheum Dis. 2010 Jun;69(6):1103-9. Epub 2009 Jun 28. Erratum in: Ann Rheum Dis. 2011 May;70(5):880.,其它目前使用的疾病活动度

10、评分SSDAI评分,Sjgrens Syndrome Disease Damage Index and disease activity index: scoring systems for the assessment of disease damage and disease activity in Sjgrens syndrome, derived from an analysis of a cohort of Italian patients. Vitali C et al. Arthritis Rheum. (2007),SCAI评分Sjgrens Systemic Clinical

11、 Activity Index,Sjgrens Systemic Clinical Activity Index (SCAI)-a systemic disease activity measure for use in clinical trials in primary Sjgrens syndrome. Rheumatology (Oxford). 2007 Dec;46(12):1845-51.,干燥综合征疾病损伤评分（SSDDI）,Sjgrens Syndrome Disease Damage Index and disease activity index: scoring systems for the assessment of disease damage and disease activity in Sjgrens syndrome, derived from an analysis of a cohort of Italian patients. Vitali C et al. Arthritis Rheum. (2007),干燥综合征损伤评分SS