CAJ | 학술논문

目的探讨初诊原发性干燥综合征(pSS)的临床特点,旨在提高对pSS的早期诊断水平.方法对2006～2007本院86例旨次诊断为pSS的住院患者临床表现及实验室指标进行回顾总结.结果除口干、眼干、关节痛外,患者血液系统受累较为多见.18岁以下青少年患者口干、眼干发生率低,而出现发热、淋巴结肿大比例高.抗SSA或SSB抗体阳性患者血液系统损害发生率高,并且红细胞沉降率(ESR)增快、球蛋白或免疫球蛋白G增高、抗核抗体(ANA)及类风湿因子(RF)阳性较抗SSA或SSB抗体阴性患者更多见.结论干燥综合征(SS)并不是都呈良性疾病过程,部分患者早期即存在重要脏器损伤.年轻患者出现不明原因发热、球蛋白增高、RF阳性者应注意排除SS可能.
목적 탐토초진원발성간조종합정(pSS)적림상특점,지재제고대pSS적조기진단수평.방법 대2006～2007본원86례지차진단위pSS적주원환자림상표현급실험실지표진행회고총결.결과 제구간、안간、관절통외,환자혈액계통수루교위다견.18세이하청소년환자구간、안간발생솔저,이출현발열、림파결종대비례고.항SSA혹SSB항체양성환자혈액계통손해발생솔고,병차홍세포침강솔(ESR)증쾌、구단백혹면역구단백G증고、항핵항체(ANA)급류풍습인자(RF)양성교항SSA혹SSB항체음성환자경다견.결론 간조종합정(SS)병불시도정량성질병과정,부분환자조기즉존재중요장기손상.년경환자출현불명원인발열、구단백증고、RF양성자응주의배제SS가능.
Objective To assess the clinical features of newly diagnosed primary Sjogren's syndrome (pSS). Methods Patients were diagnosed according to the international consensus criteria for Sjogren's Syndrome published in 2002. Clinical manifestations and laboratory tests of 86 pSS cases hospitalized in Nanjing Drum Tower Hospital in the past two years were reviewed. Results Among the 86 patients, 95.3% were female and the average disease onset age was 38.6 years. The median time from disease onset to diagnosis was 6 months. Dry mouth, dry eyes and arthralgia were the most common symptoms. Hematologic involvement was found to be prominent in these patients (69.8%). The incidence of abnormal liver function, interstitial lung disease and pulmonary arterial hypertension was 19.8%, 8.2% and 5.8% simultaneously. Younger patients (less than 18 years old) had lower frequency of dry mouth and dry eyes but higher ffrequency of fever and lymph nodes enlargement than the elderly patients (P<0.05). Patients with positive anti-SSA or anti-SSB antibodies had higher incidence of hematological changes as well as ESR than those with negative auto-antibodia. Elevated globulin/IgG and positive antinuclear antibody or rheumatoid factor (P< 0.05). Conclusion pSS is not always a benign disease. Some patients will develop vital organ damages very early and thus need to be identified and treated in time. It should not be overemphasize the importance of dry mouth and dry eyes for the diagnosis of pSS, especially in young patients. Those patients who have fever, high globulin level and positive rheumatoid factor of unknown origin should be screened for pSS.