初诊原发性干燥综合征86例临床研究  

Clinical features of newly-diagnosed primary Sjogren＇s syndrome： analysis of 86 eases

作　　者：冯学兵[1] 张华勇[1] 周康兴[1] 刘布骏[1] 孙凌云[1] 

机构地区：[1]南京大学医学院附属鼓楼医院风湿免疫科,210008

出　　处：《中华风湿病学杂志》2009年第1期44-47,共4页Chinese Journal of Rheumatology

摘　　要：目的探讨初诊原发性干燥综合征（pSS）的临床特点，旨在提高对pSS的早期诊断水平。方法对2006--2007本院86例首次诊断为pSS的住院患者临床表现及实验室指标进行回顾总结。结果除口干、眼干、关节痛外，患者血液系统受累较为多见。18岁以下青少年患者口干、眼干发生率低，而出现发热、淋巴结肿大比例高。抗SSA或SSB抗体阳性患者血液系统损害发生率高，并且红细胞沉降率（ESR）增快、球蛋白或免疫球蛋白G增高、抗核抗体（ANA）及类风湿因子（RF）阳性较抗SSA或SSB抗体阴性患者更多见。结论干燥综合征（SS）并不是都呈良性疾病过程，部分患者早期即存在重要脏器损伤。年轻患者出现不明原因发热、球蛋白增高、RF阳性者应注意排除SS可能。Objective To assess the clinical features of newly diagnosed primary Sjogren＇s syndrome （pSS）. Methods Patients were diagnosed according to the international consensus criteria for Sjogren＇s Syndrome published in 2002. Clinical manifestations and laboratory tests of 86 pSS cases hospitalized in Nanjing Drum Tower Hospital in the past two years were reviewed. Results Among the 86 patients, 95.3% . were female and the average disease onset age was 38.6 years. The median time from disease onset to diagnosis was 6 months. Dry mouth, dry eyes and arthralgia were the most common symptoms. Hematologic involvement was found to be prominent in these patients （69.8%）. The incidence of abnormal liver function, interstitial lung disease and pulmonary arterial hypertension was 19.8%, 8.2% and 5.8% simultaneously. Younger patients （less than 18 years old） had lower frequency of dry mouth and dry eyes but higher ffrequency of fever and lymph nodes enlargement than the elderly patients （P〈0.05）. Patients with positive anti-SSA or anti-SSB antibodies had higher incidence of hematological changes as well as ESR than those with negative auto-antibodia. Elevated globulin/IgG and positive antinuclear antibody or rheumatoid factor （P〈 0.05 ）. Conclusion pSS is not always a benign disease. Some patients will develop vital organ damages very early and thus need to be identified and treated in time. It should not be overemphasize the importance of dry mouth and dry eyes for the diagnosis of pSS, especially in young patients. Those patients who have fever, high globulin level and positive rheumatoid factor of unknown origin should be screened for pSS.

关 键 词：干燥综合征 自身抗体 血液系统损害 

分 类 号：R686[医药卫生—骨科学]