原发性干燥综合征合并缺血性脑血管病变的35例分析  

Analysis of 35 cases of primary sjogren's syndrome combined with ischemic cerebrovascular disease

作　　者：罗寰[1] 阮海玲[1] 陈苗苗[1] 任占芬[1] Luo Huan;Ruan Hailing;Chen Miaomiao(Department of Rheumatology,The First Affillated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院风湿免疫科,张家口075000

出　　处：《中华保健医学杂志》2018年第6期457-460,共4页Chinese Journal of Health Care and Medicine

基　　金：张家口市科技攻关计划项目(1521086D)

摘　　要：目的分析原发性干燥综合征(p SS)合并缺血性脑血管病变(CVD)患者的临床特点及相关因素。方法回顾性分析2014年9月～2015年8月就诊于河北北方学院附属第一医院的35例pSS合并CVD患者(CVD组)的临床资料,包括基础信息、临床症状与表现、影像学资料及实验室指标检测结果等。另收集同期35例单纯p SS患者(nCVD组)的临床资料进行对照分析。结果 n CVD组和CVD组性别、pSS病程、受累部位比较差异无统计学意义(P> 0.05),但后者年龄、皮肤紫癜和雷诺现象发生率明显高于前者(P <0.05)。CVD组的神经症状以反复发作的头晕、头痛为主,可伴随认知、语言障碍、癫痫小发作、感觉异常;影像学显示为不同部位的缺血性病变。与nCVD组相比,CVD组血清同型半胱氨酸(Hcy)、超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、IgG水平显著较高,差异有统计学意义(P <0.05),抗核抗体(ANA)(1∶1000)阳性率、抗干燥综合征A(SSA)抗体阳性率显著较高,差异有统计学意义(P <0.05)。logistic回归分析显示,年龄、皮肤紫癜、雷诺现象、血清炎症因子(Hcy、hs-CRP、TNF-α)浓度升高、ANA(1∶1000)阳性及SSA抗体阳性是p SS发生CVD的危险因素(P <0.05)。结论 p SS合并CVD者神经症状多样,以反复发作的头晕、头痛为主,影像学可见缺血性病变;pSS是否发生CVD与患者病程、受累部位等无关,高龄、雷诺现象、皮肤紫癜、血清炎症因子浓度升高、ANA(1∶1000)阳性及SSA抗体阳性可能增加CVD风险。Objective To analyze the clinical features of 35 patients and relevant factors of primary Sjogren's syndrome(pSS)with ischemic cerebrovascular disease(CVD).Methods Clinical data of 35 patients with pSS combined with CVD(CVD group)in the First Affiliated Hospital of Hebei North University from September 2014 to August 2015 was retrospectively analyzed,including basic information,clinical symptoms and manifestations,imaging data and the results of laboratory index test.The clinical data of another 35 patients with pure pSS(nCVD group)were collected for comparative analysis.Results There was no significant difference in nCVD group,gender of CVD group,duration of pSS and affected sites between the two groups(P>0.05),but the age,incidence of Raynaud's phenomenon,skin purpura of the latter groupwere significantly higher than those of theformer(P<0.05).The neurological symptoms in CVD group mainly included dizziness and headache,followed by accompanying cognitive,language disorders,minor epilepsy and paresthesia.Imaging showed ischemic lesions in different parts.Compared with nCVD group,levels of serum homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF-α)and IgG,the positive rates of antinuclear antibody(ANA)(1∶1000)and anti-Sjogren's syndrome A(SSA)antibody were significantly higher than those in the control group(P<0.05).Logistic regression analysis showed that age,Raynaud's phenomenon,skin purpura,levels of serum inflammatory factors(Hcy,hs-CRP,TNF-α),elevated concentration positive ANA(1∶1000)and positive SSA antibody were risk factors for CVD in pSS(P<0.05).Conclusion pSS combined with CVD patients has diverse neurological symptoms.Patients have various neurological symptoms which mainly include dizziness and headache.Imaging examination shows ischemic lesions.Whether CVD occurs in pSS has nothing to do with the patient's course,affected part,etc.Advanced age,Raynaud's phenomenon,skin purpura,increasement of serum inflammatory factor concentration positive ANA(1∶1000)and

关 键 词：原发性干燥综合征 缺血性脑血管病变 神经症状 

分 类 号：R442.8[医药卫生—诊断学]