干燥综合征患者唇腺病理特点与临床特征的相关性研究  

Correlation of lip histopathology and clinical manifestations in patients with Sjogren＇s syndrome

作　　者：田真 周炜 郝燕捷 张卓莉 

机构地区：[1]大学第一医院风湿免疫科,北京100034

出　　处：《中华风湿病学杂志》2011年第6期389-393,共5页Chinese Journal of Rheumatology

基　　金：国家“十一五”科技支撑计划项目（2008BAl59803）

摘　　要：目的探讨干燥综合征（ss）患者下唇唇腺病理与临床特点的相关性。方法对我院119例可疑ss患者的唇腺组织病理学改变、眼科检查结果、抗核抗体谱及临床特点进行分析，确诊ss84例。根据唇腺病理结果，浸润灶指数（FS）（＋）患者为64例，Fs（-）患者为20例。FS（＋）组中异位生发中心结构（Gc）（＋）患者20例，Gc（-）患者44例。计量资料采用了独立样本t检验或秩和检验，计数资料采用矿检验。结果Fs（＋）组较FS（-）组的病程及口干或眼干症状持续时间长[（70±96）、（40±29）个月与（20±28）、（10±16）个月，P〈0．05]。FS（＋）组中GC（＋）较GC（-）患者的口干、眼干持续时间更长[（72＋23）与（25~17）个月，P〈0．01]，血清中IgG水平、唇腺组织中的平均FS积分及系统累及率增高（P〈O．05）。FS（-）组中6例（占30％）患者唇腺组织有退行性变，其口干、眼干持续时间以及系统累及率高于唇腺组织正常者。结论FS（＋）组患者中GC（＋）及FS（-）患者唇腺组织的退行性变均提示患者症状重、疾病活动度及系统累及率高，提示这些改变与病情重、预后差相关，临床上应该更加关注这部分患者。Objective To evaluate the correlation between pathological findings and clinical charac teristics of patients with Sjogren＇s syndrome （SS）. Methods Eighty-four patients diagnosed with SS from 119 suspected ones at Peking University First Hospital were recruited. According to the pathological changes of lip biopsy, 64 patients were focus score （FS）（＋） and 20 patients were FS （-）. In the FS（＋） group, 20 patients had germinal center （GC）（＋） and 44 patients had no GC.X^2 test and t test were used for statistical analysis. Results The duration of symptoms of dry eyes or dry mouth in the FS （＋） group was longer than that in the FS （-） group （P〈0.05）. In the FS （＋） patients, those with GC （＋） had significantly longer duration of xerothalmia or xerostomia, higher serum IgG levels, greater FS score, and higher incidence of system involvement than those without GC patients （P〈0.05）. In the FS （-） group, lip biopsies showed degenerative changes in 6 （30%） patients. Those with degenerative changes had longer duration of dry eyes and dry mouth and higher incidence of system involvement. Conclusion GC （＋） in FS （＋） patients and degenerative changes in FS （-） patients from lip biopsy are associated with severer clinical manifestations in patients with SS, suggesting that more clinical attention should be paid to this subgroup of patients.

关 键 词：干燥综合征 涎腺 病理学 临床 

分 类 号：R593.2[医药卫生—内科学]