摘要 目的：形成EULAR/ACR对于风湿性多肌痛（PMR）的分类标准。

方法：运用一项为期6个月的前瞻性队列研究（125例新发PMR患者和169例有PMR相似表现的对照）对候选对象标准进行评估。

结果：建立如下标准：晨僵＞45min（2分）；髋部疼痛/活动受限（1分），类风湿因子（RF）和/或抗环瓜氨酸肽抗体阴性（2分）；无外周关节痛（1分）。总得分≥4可诊断。其对鉴别对照病例与PMR的敏感性为68%，特异性为78%。对肩部症状与PMR鉴别的特异度较高（88%），但对RA与PMR的鉴别特异度较低（65%）。引入超声[至少一侧肩部有三角肌下滑囊炎和/或肱二头肌腱鞘炎和/或盂肱关节滑膜炎（后部或腋部）和一侧髋部的滑膜炎和/或股骨转子滑囊炎（1分）;双侧肩部有三角肌下滑囊炎、肱二头肌腱鞘炎或盂肱关节滑膜炎（1分）]后,得分≥5分的敏感性为66%，特异性为81%。根据以上暂定标准，得出：年龄≥50岁，双肩痛且不能用其他病解释，加上有晨僵＞45min、CRP和/或ESR升高，新出现髋痛可分类为PMR。这些标准不以诊断为目的。

附：PMR分类标准得分法

必要条件：年龄≥50岁，双肩痛且不能用其他病解释，CRP和/或ESR升高。外加以上表格各项的总得分≥4分（不含超声）或≥5分（含超声），可分类为PMR。

附原文：The objective of this study was to develop European League Against Rheumatism/American College of Rheumatology classification criteria for polymyalgia rheumatica (PMR). Candidate criteria were evaluated in a 6-month prospective cohort study of 125 patients with new-onset PMR and 169 non-PMR comparison subjects with conditions mimicking PMR. A scoring algorithm was developed based on morning stiffness >45 minutes (2 points), hip pain/limited range of motion (1 point), absence of rheumatoid factor and/or anti–citrullinated protein antibody (2 points), and absence of peripheral joint pain (1 point). A score >4 had 68% sensitivity and 78% specificity for discriminating all comparison subjects from PMR. The specificity was higher (88%) for discriminating shoulder conditions from PMR and lower (65%) for discriminating RA from PMR. Adding ultrasound[at least 1 shoulder with subdeltoid bursitis and/or biceps tenosynovitis and/or glenohumeral synovitis (either posterior or axillary) and at least 1 hip with synovitis and/or trochanteric bursitis （1 point）Both shoulders with subdeltoid bursitis, biceps tenosynovitis, or glenohumeral synovitis （1 point)], a score >5 had increased sensitivity to 66% and specificity to 81%. According to these provisional classification criteria, patients >50 years old presenting with bilateral shoulder pain, not better explained by an alternative pathology, can be classified as having PMR in the presence of morning stiffness >45 minutes, elevated C-reactive protein and/or erythrocyte sedimentation rate, and new hip pain. These criteria are not meant for diagnostic purposes.

引自：Dasgupta B, Cimmino MA, Kremers HM, et al. 2012 Provisional Classification Criteria for Polymyalgia Rheumatica.A European League Against Rheumatism/American College of Rheumatology Collaborative Initiative

Arthritis & Rheumatism Vol. 64, No. 4, April 2012, pp 943–954