CAJ | 학술논문

目的探讨唇腺灶性指数与原发性干燥综合征(pSS)病情活动和脏器损伤的关系.方法收集2009年1月至2010年12月北京协和医院风湿免疫科门诊和住院诊断pSS的患者共77例,所有患者均进行口腔科和眼科检查；对患者进行血清学检测,评价脏器受累情况；所有唇腺组织评定灶性指数(FS),评价FS与pSS血清学检测结果和脏器受累的关系.结果 77例pSS患者,62例符合灶性淋巴细胞浸润性唾液腺炎(FLS),15例不符合FLS,其中6例为慢性非特异性唾液腺炎(NSCS),4例为慢性硬化性唾液腺炎(SCS),5例正常唇腺.62例FLS的患者中46例FS≥1,16例FS＜1,平均2.4±2.5.FS≥1与唾液流率、角膜染色显著相关,P＜0.05,与口眼干症状无关；FS与血清IgG、IgM和类风湿因子水平显著相关,P＜0.05;抗SSA阳性的患者FS值明显高于抗SSA阴性的患者,P＜0.05;FS与血液系统受累、肾小管酸中毒、肝功能异常、肺间质病变和周围神经病变等脏器损伤无明显相关性.结论 FLS是SS典型的唇腺病理表现,FS是评估唇腺组织淋巴细胞浸润程度的方法,FS可能与口眼科客观检查和SS病情活动相关；FS与脏器损伤无明显相关性.
목적 탐토진선조성지수여원발성간조종합정(pSS)병정활동화장기손상적관계.방법 수집2009년1월지2010년12월북경협화의원풍습면역과문진화주원진단pSS적환자공77례,소유환자균진행구강과화안과검사；대환자진행혈청학검측,평개장기수루정황；소유진선조직평정조성지수(FS),평개FS여pSS혈청학검측결과화장기수루적관계.결과 77례pSS환자,62례부합조성림파세포침윤성타액선염(FLS),15례불부합FLS,기중6례위만성비특이성타액선염(NSCS),4례위만성경화성타액선염(SCS),5례정상진선.62례FLS적환자중46례FS≥1,16례FS＜1,평균2.4±2.5.FS≥1여타액류솔、각막염색현저상관,P＜0.05,여구안간증상무관；FS여혈청IgG、IgM화류풍습인자수평현저상관,P＜0.05;항SSA양성적환자FS치명현고우항SSA음성적환자,P＜0.05;FS여혈액계통수루、신소관산중독、간공능이상、폐간질병변화주위신경병변등장기손상무명현상관성.결론 FLS시SS전형적진선병리표현,FS시평고진선조직림파세포침윤정도적방법,FS가능여구안과객관검사화SS병정활동상관；FS여장기손상무명현상관성.
Objective To explore the correlation between labial salivary gland focus score (FS)and severity of Sj(o)gren's syndrome patients.Methods From January 2009 to December 2010,a total of 77 patients with primary Sj(o)gren's syndrome were recruited to undergo minor salivary gland biopsy,Schirmer's test,unstimulated whole salivary flow,organ function and serological test.Focus score was calculated for all biopsy samples.And the correlation between focus score and serological test and organ function damage was evaluated.Results Their pathological examinations revealed focal lymphocytic sialadenitis (n =62),10 cases with non-specific or sclerosing chronic sialadenitis (n =10) and normal features (n =5).Among 62 cases with focal lymphocytic sialadenitis,46 cases had FS ≥ 1 and another 16 FS ＜ 1.The median FS was 2.4 ± 2.5.FS ≥ 1 was strongly associated with unstimulated whole salivary flow rates and ocular staining score (P ＜ 0.05),but not significantly with dry mouth or eyes.FS was significantly correlated with serum immunoglobin G (IgG),immunoglobin M (IgM) and rheumatoid factor level (P ＜ 0.05).Those with positive anti-SSA had higher FS level than those with negative anti-SSA antibody (P ＜ 0.05).In addition,FS level was not significantly associated with organ function damage.Conclusion Prior to determining FS,distinguishing focal lymphocytic sialadenitis from other types of sialadenitis is essential in assessing salivary gland biopsy.And the FS level might be associated with disease activity and positive anti-SSA.No correlation exists between FS and organ function damage.