老年干燥综合征患者临床特点及相关因素分析  

Clinical features and the related factors of primary Sjogren＇s syndrome in elderly patients

作　　者：程永静[1] 王芳[1] 张春媚[1] 高利云[1] 郑利[1] 徐华[1] 高明[1] 黄慈波[1] 

机构地区：[1]卫生部北京医院风湿免疫科,100730

出　　处：《中华老年医学杂志》2011年第8期667-670,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨不同年龄原发性干燥综合征（pSS）患者的临床、实验室检查及治疗特点。方法收集84例干燥综合征患者的临床资料，按年龄分为中青年组和老年组，回顾性分析其临床特点、实验室指标及药物治疗的差异，并应用卡方检验进行统计学分析。结果干燥综合征患者84例，老年组30例，中青年组54例；老年组患者口干、眼干及猖獗龋的阳性率分别为80．0％、76．7％及43．3％，明显高于中青年组57．4％、51．9％及20．4％（均为P〈0．05）；类风湿因子（RF）升高、抗SSA抗体及抗SSB抗体阳性的机率分别为13．0％、36．7％及16．7％，明显低于中青年组44．4％、59．3％及42．6％（均为P〈0．05）；老年组与中青年组比较，眼科特异性检查的阳性率（Schirmer实验，角膜荧光染色，泪膜破裂时间）、腮腺同位素显影的阳性率、免疫球蛋白升高（IgG，IgA，IgM）均差异无统计学意义；老年组白细胞减低及甲状腺受累的阳性率分别为13．3％及10．0％，均低于中青年组48．1％及37．0％（P〈0．05）。老年组患者应用白芍总苷单药治疗的比例（33．3％）高于中青年组（14．8％）（P〈0．05），而用羟氯喹治疗的比例（16．7％）低于中青年组（40．7％）（P〈0．05）。结论老年干燥综合征患者口干、眼干及猖獗龋等临床症状及体征更为典型，抗SSA抗体及抗SSB抗体等特异性抗体的阳性率略低，合并白细胞减低及甲状腺疾病的机率低，诊断更多的依赖唇腺活检。Objective To investigate the differences in clinical, laboratory and therapeutic aspects of primary Sjogren＇s syndrome （pSS） between young/middle-age group and old group. Methods The 84 pSS patients were divided into the young and middle-age group （n=54） and the old group （n = 30）. The differences in clinical features, laboratory indices and drug therapy were retrospectively analyzed. The chi-square test was used for statistical analysis. Results The positive incidences of xerostomia, dry eye symptom and rampant teeth were 80.0%, 76.7% and 43.3% respectively in the old group. And they were all significantly higher than in young and middle-aged group （57.4%, 51.9% and 20.4%, all P〈0.05）. The positive rates of rheumatoid factor （RF） elevation, antiRo/SSA and antiLa/SSB antibodies were 13.0%, 36.7% and 16.7% in the old group, and significantly lower than in young and middle-age group （44.4%, 59.3% and 42.6%, all P〈0. 05）. The incidences of leukopenia and thyroid gland involvement were much lower in the aged group （13.3% and 10.0%） than in the young and middle-age group （48.1% and 37.0%, P〈0. 05）. The percentage of patients receiving hydroxychloroquine as the main medicine was much lower in the aged group than in the young and middle-age group （16.7% vs. 40.7%, P〈0. 05）, while percentage of treatment with exclusive glucosides of Paeony Capsules was much higher （33.3% vs. 14.8% , P〈 0.05）. There were no statistical differences between two groups in ophthalmological examination, immunoglobulin level and sialography. Conclusions Those pSS patients with late onset exhibit more abnormalities in clinical parameters, but fewer in immunological parameters, which may be helpful in estimating prognosis and pathogenetie factors in pSS.

关 键 词：干燥综合征 白细胞减少 自身抗体 

分 类 号：R593.2[医药卫生—内科学]