3类新型慢性唾液腺炎的诊断和治疗  

Studies on newly recognized chronic sialadenitis

作　　者：俞光岩[1,2] 柳登高 李巍[1] 洪霞[1,2] 张严妍 朱文瑄 张可夫 李潇 栗占国 刘燕鹰[5] 陈艳 高岩[6] 苏家增[1] YU Guang-yan;LIU Deng-gao;LI Wei;HONG Xia;ZHANG Yan-yan;ZHU Wen-xuan;ZHANG Ke-fu;LI Xiao;LI Zhan-guo;LIU Yan-ying;CHEN Yan;GAO Yan;SU Jia-zeng(Department of Oral&Maxillofacial Surgery,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key laboratory of Digital Stomatology,Beijing 100081,China;Center of Stomatology,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China;Department of Oral Radiology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key laboratory of Digital Stomatology,Beijing 100081,China;Department of Rheumatology and Immunology,Peking University People’s Hospital,Beijing,100044,China;Department of Rheumatology and Immunology,Capital Medical University Affiliated Beijing Friendship Hospital,100050,China;Department of Oral Pathology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院口腔颌面外科,北京100081 [2]北京大学深圳医院口腔医学中心,广东深圳518036 [3]北京大学口腔医学院·口腔医院口腔放射科,北京100081 [4]北京大学人民医院风湿免疫科,北京100044 [5]首都医科大学附属北京友谊医院风湿免疫科,北京100050 [6]北京大学口腔医学院·口腔医院口腔病理科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2022年第1期13-17,共5页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(82081240420、81974151、81671005、81470756、81611540351)。

摘　　要：慢性唾液腺炎是组织病理学以唾液腺慢性炎症为主要表现的一类疾病,有传统的已经熟知的慢性唾液腺炎,也有新近才被认识或者受到重视的慢性唾液腺炎,即新型慢性唾液腺炎;有唾液腺本身局部病变为主的疾病,也有唾液腺作为靶器官受损的全身性疾病。传统的已经熟知的慢性唾液腺炎有慢性复发性腮腺炎、唾液腺结石伴发的唾液腺炎等。Some kinds of chronic sialadenitis were recognized during the recent years.They have specific pathogenesis,clinical and histopathologic appearances,and require specific treatment.IgG4-related sialadenitis(IgG4-RS)is one of the immune-mediated diseases,characterized by tumefactive lesions.The incidence of IgG4-RS obviously increased during the past 30 years.The study on the potential relationship between occupational exposure to chemical substances and the incidence of IgG4-RS showed that subjects with occupational exposure to agents known to cause IgG4-RD had an increased risk for IgG4-RS.Surgical excision of involved SMG could not control the disease progression,which is not recommended for treatment of IgG4-RS.The combination of glucocorticoid and steroid-sparing agents is effective for treating IgG4-RS,and restores salivary gland function.Radioiodine induced sialadenitis(RAIS)is one of the common complications of postoperative adjuvant treatment of differentiated thyroid cancer by ^(131)I.The incidence of the disease is related to radiation dosage.Clinically,the patients suffered from swelling and tenderness in the buccal or submandibular regions,especially during the mealtime.Imaging appearances are similar to those of chronic obstructive sialadenitis.Conservative managements,such as gland massage,sialagogues,are the mainstream methods in the treatment of RAIS.Sialendoscopy is feasible for RAIS,but not as effective as conventional obstructive sialadenitis(COS).Therefore the prevention of RAIS is crucial.Eosinophilic sialodochitis(ES)is a new type of chronic inflammatory disease of the salivary gland related to allergy.It has characteristics of swelling of multiple major salivary glands,strip-like gelatinous plugs discharged from the duct orifice of the gland,elevated level of serum IgE and eosinophils in peripheral blood,infiltration of eosinophils and IgE positive plasma cells in the tissues,allergic history,increased expression of allergy-related cytokines,such as IL-4,IL-5,IL-13,and eotaxin,which suggest a

关 键 词：IgG4相关唾液腺炎 ^(131)I相关唾液腺炎 嗜酸性唾液腺导管炎 唾液腺 下颌下腺 腮腺 

分 类 号：R782.3[医药卫生—口腔医学]