涎腺超声联合血清BAFF检测在原发性干燥综合征诊断中的价值  

Serum BAFF test combined with salivary gland ultrasonography in diagnosis of primary Sjogren's syndrome

作　　者：耿保庆 黄娴倩[1] 干敏芝[1] 彭勇[1] 朱梦雅[1] 应颖[1] 黄海燕[1] 陈勇[1] 

机构地区：[1]宁波市第二医院风湿免疫科,315010

出　　处：《浙江医学》2017年第21期1868-1871,共4页Zhejiang Medical Journal

基　　金：2017年宁波市自然基金(2017A610208)

摘　　要：目的探讨涎腺超声联合血清B淋巴细胞刺激因子(BAFF)检测在原发性干燥综合征(pSS)诊断中的临床价值。方法选择pSS患者80例(pSS组),类风湿关节炎(RA)患者60例(RA组),健康体检者20例(健康对照组)。采用ELISA法检测各组血清BAFF、增殖诱导配体(APRIL)、TNF-α、IL-1β及IL-6水平;通过二维超声评估pSS患者涎腺受累情况。分析比较各组血清BAFF、APRIL、TNF-α、IL-1β、IL-6水平,并分析pSS患者血清BAFF、APRIL、TNF-α、IL-1β、IL-6与涎腺超声评分的相关性。结果3组血清BAFF、IL-1β、TNF-α比较差异均有统计学意义(均P<0.05),其中pSS组患者血清BAFF、IL-1β、TNF-α水平明显高于RA组与健康对照组,差异均有统计学意义(均P<0.05)。pSS患者血清BAFF与涎腺评分呈负相关(r=-0.462,P<0.05),血清IL-1β与涎腺评分呈正相关(r=0.403,P<0.05)。涎腺超声、血清BAFF对pSS诊断的灵敏度高于抗干燥综合征A抗原(SSA)/干燥综合征B抗原(SSB)、类风湿因子(RF),差异均有统计学意义(均P<0.05)。对于涎腺超声评分≤2分的早期pSS患者,涎腺超声联合BAFF检测诊断特异度达到96.77%。结论pSS患者血清BAFF在疾病的早期即有明显升高,有助于早期诊断。涎腺超声对pSS的诊断比抗SSA/SSB有更高的灵敏度,特异度相当;BAFF对pSS的诊断比抗SSA/SSB灵敏度高,但特异度较低。对于涎腺超声评分≤2分的pSS患者,涎腺超声联合血清BAFF检测可提高诊断的特异度,可作为早期筛查指标。Objective To assess the value of serum BAFF level combined with salivary gland ultrasonography in diagnosis of primary Sjogren＇s syndrome（pSS）. Methods The serum levels of BAFF, APRIL, TNF-α, IL-1β and IL-6 were measured by ELISA in 80 pSS patients, 60 rheumatoid arthritis（RA） patients and 60 healthy controls. Salivary gland was examined with two-dimensional ultrasonography in three groups. The correlation of serum levels of BAFF, APRIL, TNF-α, IL-1β, IL-6 and salivary gland ultrasonography with pSS was evaluated. Results The serum levels of BAFF, IL-1β, TNF-α in pSS patients were significantly higher than those in RA patients and healthy controls（all P0.05）, while there were no significant differences in serum levels of APRIL and IL-6 among tree groups. The salivary gland ultrasound scores was negatively correlated with serum BAFF level（r=-0.462, P〈0.05） and positively correlated with IL-1β level（r=0.403, P〈0.05）. The sensitivity of salivary ultrasonography in diagnosis of pSS was higher than that of SSA/SSB and the specificity was similar. The sensitivity of serum BAFF in diagnosis of pSS was higher than that of SSA/SSB, but the specificity was lower. For pSS patients with ultrasonic score 2 min, the specificity of ultrasonography combined with BAFF was increased to 96.77%. Conclusion Serum BAFF measurement combined with salivary gland ultrasound examination can be used for screening and diagnosis of primary Sjogren＇s syndrome.

关 键 词：B淋巴细胞刺激因子 涎腺超声 原发性干燥综合征 

分 类 号：R593.2[医药卫生—内科学]