加强筛查问卷的应用尽早发现银屑病关节炎

Emphasis on using a screening questionnaire to identify early psoriatic arthritis

银屑病关节炎(psoriatic arthritis,Ps A)的临床表现复杂多样,常常在银屑病皮损发生后的5~10年内发生。早期诊断对于改善Ps A的结局非常重要,但是Ps A在国内外的诊断延迟(常常大于2年)现象非常普遍。迄今已有多种筛查工具问世,我们在国内银屑病患者中验证了4种主流筛查问卷的效能,其中早期银屑病关节炎筛查问卷筛查Ps A的敏感性和特异性的综合表现稍优于其他筛查工具;银屑病流行病学筛查工具问卷最为简便,且其综合表现也尚可。对所有银屑病患者常规应用早期银屑病关节炎筛查问卷或银屑病流行病学筛查工具问卷可尽早发现漏诊的Ps A患者。

Clinical manifestations of psoriatic arthritis(Ps A)are diversity and usually presented 5-10 years after the onset of skin psoriasis.Early diagnosis of Ps A iscritical for the better prognosis.Unfortunately,diagnostic delay(usually>2 years)of Ps A isvery common in domestic and abroad.Several questionnaires have been developed for screening possible Ps A until now.We have validated the performances of 4 major screening tools in Chinese patients with psoriasis.Among them,the Early Arthritis for Psoriatic Patients(EARP)questionnaire has the best balanced sensitivity and specificity,and the psoriasis epidemiology screening tool questionnaire(PEST)is the simplest one with acceptable performance.Routinely screen of psoriasis with EARP or PEST questionnaire is recommended in order to identify Ps A patients with EARP early.