摘要
目的:观察原发性和继发性干燥综合征(SS)患者的不同特点,为临床诊断SS提供新的信息。方法:选取原发性SS(pSS)患者44例,继发性SS(sSS)患者37例,其中17例继发于系统性红斑狼疮(SS-SLE),20例继发于类风湿关节炎(SS-RA)。比较pSS和sSS临床特征和实验室结果的不同特点。结果:1)pSS、SS-SLE和SS-RA发病年龄分别为(45.3±11.7)岁,(42.9±11.7)岁和(53.2±13.8)岁。2)pSS发热、唇腺活检、抗SSA和抗SSB阳性率明显高于SS-RA,猖獗齿阳性率明显高于SS-SLE(P均<0.05)。SS-SLE组蛋白尿发生率较pSS多见(P=0.000),肾小管酸中毒有增多趋势(P=0.06)。SS-RA组关节痛发生率较pSS多见。pSS腮腺肿痛较sSS明显多见(P=0.003),周围神经病变的发生率较sSS少见(P=0.044)。3)pSS血红蛋白(HGB)降低的发生率比sSS明显少见(P=0.045),且SS-SLE白细胞(WBC)、血K+和补体C3降低比pSS明显增多,SS-RA类风湿因子(RF)和C反应蛋白(CRP)增高比pSS多见。4)pSS和sSS的ANA核型以颗粒型最常见,此外pSS核仁型、核膜型,sSS均质型和胞浆型相对较多见。结论:pSS与sSS比较,起病比SS-RA早,临床特征典型,腮腺肿痛明显,出现蛋白尿、贫血、C3降低及周围神经病变较少,ANA核型以颗粒型、核仁型、核膜型多见。
Objective： To investigate the different characteristics in patients with primary and secondary Sjogren＇s syndrome（SS）, in order to provide new information for diagnosis of SS. Methods： 44 primary Sjogren＇s syndrome（pSS） and 37 secondary Sjogren＇s Syndrome（sSS） patients were enrolled （ 17 patients secondary to SLE, SS-SLE and 20 patients secondary to RA, SS-RA ）. The different clinical features and laboratory examination in patients with pSS and sSS were compared. Results： The mean age at onset was （45.3 ± 11. 7）ys in pSS and was （42.9 ± 11. 7）ys in SS-SLE and was （53.2 ± 13.8）ys in SS-RA respectively, pSS patients were younger than those with SS-RA （P = 0.02）. We found higher percentage of fever, labial gland biopsy and anti-SS-A/B antibodies in pSS patients than those with SS-RA and higher percentage of dental necrosis than those with SS-SLE （P 〈 0.05）. More proteinuria and renal tubule acidosis were found in SS-SLE patients than those in pSS （P = 0.000, P = 0.06）. More arthralgia was found in SS-RA patients than those with pSS. More parotid gland enlargement was found in pSS patients than in the sSS ones （ P = 0. 003 ）. PSS presented a lower prevalence of peripheral neuropathy and hemoglo- bin than sSS patients （P = 0.044, 0.045 ）. The frequency of the decreasing of white blood cell, serum K and C3 in SS-SLE and rheumatoid factor and c-reactive protein in SS-RA patients were higher than those of pSS. The granular pattern of ANA was the most common pattern in pSS and sSS. Besides, nucleolar pattern and nuclear membrane pattern were more often in pSS cases, and homogeneous pattern and kytoplasm pattern were more often in sSS. Conclusion： Compared with patients with pSS and sSS, the pSS patients were younger than SS-RA ones in disease onset and clinical features tend to be more typical. PSS patients may have more common parotid gland enlargement and present less frequently to have proteinuria, anaemia, C3 decreasing and peripheral neuropathy. More nucleolar pattern and nuclear membrane pattern were found in pSS.
出处
《军医进修学院学报》
CAS
北大核心
2008年第5期371-373,共3页
Academic Journal of Pla Postgraduate Medical School
关键词
干燥综合征
红斑狼疮
系统性
关节炎
类风湿
Sjogren＇s syndrome
lupus erythematosus, systemic
arthritis
rheumatoid
