中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2012年
3期
169-172
,共4页
陈海支%蒋峰%杨孝兵%秦理%刘坚白%陈士芳%王友庆%费小聪%陶百平%宋宝华%任丽华%那万秋
陳海支%蔣峰%楊孝兵%秦理%劉堅白%陳士芳%王友慶%費小聰%陶百平%宋寶華%任麗華%那萬鞦
진해지%장봉%양효병%진리%류견백%진사방%왕우경%비소총%도백평%송보화%임려화%나만추
干燥综合征%精神障碍%回顾性研究
榦燥綜閤徵%精神障礙%迴顧性研究
간조종합정%정신장애%회고성연구
Sjogren's syndrome%Mental disorders%Retrospective studies
目的 探讨原发性干燥综合征( pSS)所致精神障碍的临床特征.方法 对31例由风湿免疫科和精神科联合会诊确诊为pSS所致精神障碍住院患者的临床资料,从临床表现、辅助检查、治疗措施及疗效等方面进行回顾性分析.结果 31例患者中男7例,女24例；确诊前有23例在精神科首次就诊住院,5例在精神科多次就诊住院,3例在风湿免疫科就诊住院.物理检查结果均无特异性.31例患者的红细胞沉降率、C反应蛋白和免疫球蛋白G均升高；唇腺组织学检查均显示,腺上皮萎缩,灶性淋巴细胞浸润；24例抗核抗体阳性,25例抗干燥综合征抗原A抗体阳性.确诊pSS前主要精神症状以焦虑和抑郁为主要表现.21例患者的汉密尔顿焦虑量表(HAMA)评分为8～25( 15.84±5.76)分,其中6例患者汉密尔顿抑郁量表(17项)评分为14～23( 19.50±4.23)分,伴随症状体征出现较早,自觉疲乏21例,口干18例,皮肤干燥17例,睡眠障碍(入睡困难或早醒)16例,眼干涩14例,猖獗龋齿12例.通过系统治疗,31例患者中28例精神症状明显好转,2例继续精神科治疗,1例因脑炎死亡.结论 pSS所致精神障碍临床表现复杂多样,缺乏特异性；精神障碍多为焦虑和抑郁等；很多躯体症状易与焦虑或抑郁混淆.
目的 探討原髮性榦燥綜閤徵( pSS)所緻精神障礙的臨床特徵.方法 對31例由風濕免疫科和精神科聯閤會診確診為pSS所緻精神障礙住院患者的臨床資料,從臨床錶現、輔助檢查、治療措施及療效等方麵進行迴顧性分析.結果 31例患者中男7例,女24例；確診前有23例在精神科首次就診住院,5例在精神科多次就診住院,3例在風濕免疫科就診住院.物理檢查結果均無特異性.31例患者的紅細胞沉降率、C反應蛋白和免疫毬蛋白G均升高；脣腺組織學檢查均顯示,腺上皮萎縮,竈性淋巴細胞浸潤；24例抗覈抗體暘性,25例抗榦燥綜閤徵抗原A抗體暘性.確診pSS前主要精神癥狀以焦慮和抑鬱為主要錶現.21例患者的漢密爾頓焦慮量錶(HAMA)評分為8～25( 15.84±5.76)分,其中6例患者漢密爾頓抑鬱量錶(17項)評分為14～23( 19.50±4.23)分,伴隨癥狀體徵齣現較早,自覺疲乏21例,口榦18例,皮膚榦燥17例,睡眠障礙(入睡睏難或早醒)16例,眼榦澀14例,猖獗齲齒12例.通過繫統治療,31例患者中28例精神癥狀明顯好轉,2例繼續精神科治療,1例因腦炎死亡.結論 pSS所緻精神障礙臨床錶現複雜多樣,缺乏特異性；精神障礙多為焦慮和抑鬱等；很多軀體癥狀易與焦慮或抑鬱混淆.
목적 탐토원발성간조종합정( pSS)소치정신장애적림상특정.방법 대31례유풍습면역과화정신과연합회진학진위pSS소치정신장애주원환자적림상자료,종림상표현、보조검사、치료조시급료효등방면진행회고성분석.결과 31례환자중남7례,녀24례；학진전유23례재정신과수차취진주원,5례재정신과다차취진주원,3례재풍습면역과취진주원.물리검사결과균무특이성.31례환자적홍세포침강솔、C반응단백화면역구단백G균승고；진선조직학검사균현시,선상피위축,조성림파세포침윤；24례항핵항체양성,25례항간조종합정항원A항체양성.학진pSS전주요정신증상이초필화억욱위주요표현.21례환자적한밀이돈초필량표(HAMA)평분위8～25( 15.84±5.76)분,기중6례환자한밀이돈억욱량표(17항)평분위14～23( 19.50±4.23)분,반수증상체정출현교조,자각피핍21례,구간18례,피부간조17례,수면장애(입수곤난혹조성)16례,안간삽14례,창궐우치12례.통과계통치료,31례환자중28례정신증상명현호전,2례계속정신과치료,1례인뇌염사망.결론 pSS소치정신장애림상표현복잡다양,결핍특이성；정신장애다위초필화억욱등；흔다구체증상역여초필혹억욱혼효.
Objective To investigate the clinical features of patients with mental disorder caused by primary sjogren syndrome ( pSS ).Methods The retrospective analysis was made on the perspectives of clinical manifestation,accessory examinations,therapeutic measure and treatment effect,etc.,on 31 inpatients who were diagnosed of mental disorder caused by pSS through the collaborative diagnosis with the doctors from departments of rheumatism immunity and psychosis.Results Twenty-four patients were female.Before the correct diagnoses being made,23 patients were hospitalized to the psychosis department in the first diagnosis,5 were diagnosed as mental disorders and shifted into the hospital in the psychosis department,and 3 were diagnosed in the rheumatism immunity department.The physical examination was nonspecific.The erythrocyte sedimentation rate( ESR),C-reactive protein(CRP) and immunoglobulin in the 31 patients were all increased,while gland epithelial atrophy was examined by the labial gland histology examination,foci lymphocyte infiltrates were also found.The antinuclear antibodies (ANA) was positive in 24 patients,the anti-sjogren syndrome antigen A (anti-SSA) was positive in 25 patients. Anxiety and depression were regarded as the primary mental symptom before the diagnosis of pSS.The score of Hamilton Anxiety Scale ( HAMA ) of 21 patients was 8 -25 ( 15.84 ± 5.76 ),while the score of Hamilton Depression Scale ( 17 items,HAMD17 ) of 6 patients was 14 - 23 ( 19.50 ± 4.23 ),and accompanying physical symptoms as weary ( 21 patients),thirsty ( 18 patients),dry skin ( 17 patients ),sleep disturbances ( sleep continuity disturbance and early awake) ( 16 patients),dry eye( 14 patients) and various dental caries( 12patients) occurred early.With the systematic treatment,28 patients had the marked improvement,2 had continuous psychosis treatment,and I died because of encephalitis,Conclusion The clinical manifestations of mental disorder caused by pSS are various and have comparatively difference without specificity.Most of the mental disorders are manifested as depression and anxiety,while lots of physical symptoms are confused with anxiety and deporession.
