摘要
目的：为提高对干燥综合征（ＳＳ）并发完全型肾小管性酸中毒（ＲＴＡ）的认识。方法：对２２ 例ＳＳ合并完全型ＲＴＡ患者的临床资料进行总结。然后对其中２１ 例原发ＳＳ（ｐＳＳ）合并完全型ＲＴＡ 的患者与另外３７ 例无肾脏受累的ｐＳＳ进行对比分析。结果：除１ 例同时合并有提示近端肾小管受损的糖尿和尿酸尿外，均突出表现为Ⅰ型肾小管性酸中毒。发作性软瘫、多饮多尿和骨痛／关节痛是最常见的症状；多数患者（６８．１８％ ， １５／２２）无口眼干燥症状或较轻微；与无肾脏受累的ｐＳＳ患者相比，ｐＳＳ合并ＲＴＡ患者发生明显口眼干燥及淋巴结肿大较少（Ｐ分别＜０．０１ 和０．０５），而高球蛋白血症发生率及抗ＳＳＡ 阳性率较高（Ｐ分别＜ ０．０１ 和０．０５）；对１６ 例患者平均随访４．７８ 年，无１ 例死亡。结论：尽管ＳＳ合并完全型ＲＴＡ有典型的Ⅰ型ＲＴＡ症状和明显的免疫学改变，但其原发的干燥症状较轻，预后较好。
Objective:To enhance the understanding of the clinical features of Sjogren′s syndrome complicated with complete renal tubular acidosis (SSRTA).Methods:The clinical features of 22 patients with SSRTA were summarized and compared with 37 primary SS(pSS) patients whose kidneys were not involved. Results:All patients presented mainly clinical manifestations of type Ⅰ RTA (distal RTA) except 1 patient suffered simultaneously from renal glucosuria and uricaciduria indicating involvement of proximal renal tubules. Most patients of SSRTA (68.18%, 15/22) had no or only mild dry mouth and dry eyes. As compared with single pSS patients, SSRTA patients tended to have more obvious hyperglobulinemia, but less typical xerostomia, keratoconjunctivitis sicca and lymphadenovarix ( P <0 01 or 0 05). Positive rate of anti SSA antibody in SSRTA group was significantly higher ( P <0 05). An over 4 year follow up showed that none of the SSRTA patients died. Conclusion:The SSRTA patients have mild sicca symptoms and favorable prognosis despite the existence of typical symptoms of type Ⅰ RTA and obvious immune abnormalities.
出处
《军医进修学院学报》
CAS
1999年第4期254-255,共2页
Academic Journal of Pla Postgraduate Medical School
