Gentric-Tilly Armelle
Service de Médecine Interne, CHU La Cavale Blanche, 29285 Brest.
Ann Med Interne (Paris). 2002 Oct;153(6):378-82.
Sjögren's syndrome is an immune exocrinopathy. This paper will deal with the primary Sjogren's syndrome non associated with another rheumatologic disease (polyarthritis or systemic lupus erythematosus). Its prevalence is claimed to increase with age. The main clinical manifestation is salivary and/or ocular dryness due to a lymphocytic infiltration of the salivary or lacrimal glands or both. However, sicca symptoms are very frequent in the elderly, most often iatrogenic. The problem, particularly in this population, is the diagnosis of Sjögren's syndrome. There are yet no consensual criteria, the most used in the literature are the European criteria, published in 1993 and revised in 1996. Some tests, such as the Schirmer's test and non stimulated salivary flow, are not specific over 60 years. The results of other tests are discussed as the focus score on the lip salivary glands biopsy. The diagnosis of Sjögren's syndrome should be envisaged in the elderly, when systemic manifestations are associated with sicca symptoms.
干燥综合征是一种免疫性外分泌腺病。本文将探讨与其他风湿性疾病(多关节炎或系统性红斑狼疮)无关的原发性干燥综合征。据称其患病率随年龄增长而增加。主要临床表现为由于唾液腺或泪腺或两者的淋巴细胞浸润导致的唾液和/或眼部干燥。然而,干燥症状在老年人中非常常见,大多数情况下是医源性的。问题在于,尤其是在这一人群中,干燥综合征的诊断。目前尚无共识性标准,文献中最常用的是1993年发布并于1996年修订的欧洲标准。一些检查,如泪液分泌试验和非刺激性唾液流量,在60岁以上人群中并不具有特异性。其他检查结果,如唇唾液腺活检的焦点评分,也在讨论之中。当老年患者出现全身表现并伴有干燥症状时,应考虑干燥综合征的诊断。