摘要(来自荷兰研究): 目的 为提高早期类风湿关节炎（RA）诊断的特异性和敏感性(与1987年ACR标准相比)，ACR和EULAR在2010年提出了RA新的分类标准。本研究旨在评价1987年ACR标准和2010 ACR/EULAR标准在早期关节炎诊断分类中的差别，并测试2010年ACR/EULAR标准的特点。

方法 Leiden EAC研究组共入选2258例早期关节炎患者，基线时判定是否符合1987年和2010年RA分类标准，1年后评估诊断情况。应用如下方法来判定2010标准的敏感性和特异性：随访1年间是否开始用MTX或任何DMARD治疗，以及随访5年中是否有持续关节炎。

结果 第1次就诊时，分别有1099例和726例患者符合2010年标准和1987年标准，其中符合1987年标准的726例患者中有82例不符合2010年标准。发病第1年间（并非基线）符合1987年标准的患者中，有68%在基线时符合2010年标准。开始符合2010年标准的患者中，有18%的患者随访1年间不符合该标准。2010年标准的敏感性和特异性：以MTX治疗作为结果时分别为0.84和0.6，用任何DMARD治疗作为结果时分别为0.74和0.74，以关节炎持续作为结果时分别为0.71和0.65。

结论 与1987年标准相比，2010标准可诊断出更多的RA 患者，并能更早地诊断出RA。2010标准的分辨能力较好。

附原文：Abstract OBJECTIVE: New criteria to classify RA have been derived in order to increase the specificity and sensitivity for early RA compared to the 1987 ACR-criteria. This study evaluated differences in classification between the 1987 ACR-criteria and 2010 ACR/EULAR-criteria in an early arthritis cohort and determined the test characteristics of the 2010 ACR/EULAR-criteria. METHODS: 2258 early arthritis patients included in the Leiden EAC cohort were studied. Fulfilment of the 1987- and 2010-criteria for RA was determined at baseline. The diagnosis at 1 year was assessed. The sensitivity and specificity of the 2010-criteria were determined using the following outcome measures: initiation of methotrexate-therapy or any DMARD-therapy during the first year of follow-up and having persistent arthritis during 5 years of follow-up. RESULTS: At first presentation, 1099 patients fulfilled the 2010-criteria and 726 patients the 1987-criteria for RA. 82 of the 726 patients fulfilling the 1987-criteria did not fulfill the 2010-criteria. 68% of the patients that fulfilled the 1987-criteria during the first year of the disease but not at baseline, did fulfill the 2010-criteria at baseline. The 2010 classification also led in 18% to a revoked classification at year 1. The sensitivity and the specificity were 0.84 and 0.60 with methotrexate therapy as outcome and 0.74 and 0.74 with DMARD therapy as outcome. With arthritis persistency as outcome, the sensitivity and specificity were 0.71 and 0.65. CONCLUSION: Compared to the 1987-criteria, the 2010-criteria classify more patients with RA and in an earlier phase. The discriminative ability of the 2010 criteria is reasonable.

引自：van der Linden MP, Knevel R, Huizinga TW, van der Helm-van Mil AH Classification of rheumatoid arthritis - comparison of the 1987 ACR and 2010 ACR/EULAR criteria. Arthritis Rheum. 2010 Oct 21. [Epub ahead of print]