干燥综合征诊断标准的演进  

Evolution of diagnostic criteria for Sj?gren′s Syndrome

作　　者：陶谦[1] 梁培盛 TAO Qian;LIANG Peisheng(Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology,Guangzhou 510055, China)

机构地区：[1]中山大学附属口腔医院.光华口腔医学院.广东省口腔医学重点实验室,广东广州510055

出　　处：《口腔疾病防治》2019年第5期273-279,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省科技计划项目(2017A020211025)

摘　　要：干燥综合征缺乏单一而客观的诊断指标,其诊断常需要根据分类标准进行综合分析。随着对本病的研究和认识的深入,分类标准也不断进行调整和修订,诊断的敏感性及特异性逐渐提升,很大程度上具备诊断标准的价值。自1965年至今,先后有十余个干燥综合征诊断标准面世,经过长期的争论及实践,具有广泛适用性的国际性标准逐渐取代了地区性标准。诊断标准的演进中,诊断细则及评估方法亦日趋简练而统一,特异性差、操作难度大而不便于临床推广应用的技术陆续被淘汰,逐渐形成了以客观检查为主、主观症状为辅的诊断体系,其中唇腺活检以及血清自身抗体具有极为重要的诊断价值。诊断细则的优化使本疾病的诊断日益高效、科学。本文通过回顾分析干燥综合征诊断标准的特点和差异,结合本疾病研究的发展历程,分析不同诊断标准间相互演变和进步的内在逻辑,希望对本疾病的诊断、治疗及相关研究有所裨益。Sjogren′s syndrome lacks a single and objective diagnostic index, and its diagnosis often requires comprehensive analysis according to classification criteria. With increasing research and a deepening understanding of the disease, the classification criteria are constantly being adjusted and revised. The sensitivity and specificity of the diagnosis have gradually improved, which has the value of diagnostic criteria largely. Since 1965, more than ten diagnostic criterias for Sjogren′s syndrome have been published. After debate and experience, international criteria with wide applicability have gradually replaced regional criteria. In the evolution of the diagnostic criteria, the diagnostic rules and evaluation methods have become more concise and unified. Techniques with poor specificity and operative difficulty, which are not easy to popularize or apply in the clinic, have gradually been eliminated. A diagnostic system based on an objective examination and subjective symptoms has gradually formed, and lip gland biopsy and serum autoantibody sampling have demonstrated great diagnostic value. The optimization of diagnostic rules makes the diagnosis of this disease more efficient and scientific. This paper reviews the characteristics of and differences in diagnostic criteria for Sjogren′s syndrome and analyzes the internal logic of the evolution of different diagnostic criteria in light of development in research on the disease with the hope of benefitting the diagnosis, treatment and related research of Sjogren′s syndrome.

关 键 词：干燥综合征 舍格伦综合征 原发性干燥综合征 继发性干燥综合征 结膜角膜染色评分 唾液流率 诊断标准 分类标准 

分 类 号：R781.7[医药卫生—口腔医学]