Institute of Ageing and Health and NIHR Biomedical Research Centre for Ageing, Newcastle University, Newcastle upon Tyne, UK.
Ann Rheum Dis. 2012 Dec;71(12):1973-9. doi: 10.1136/annrheumdis-2011-201009. Epub 2012 May 5.
To determine the prevalence of autonomic dysfunction (dysautonomia) among patients with primary Sjögren's syndrome (PSS) and the relationships between dysautonomia and other clinical features of PSS.
Multicentre, prospective, cross-sectional study of a UK cohort of 317 patients with clinically well-characterised PSS. Symptoms of autonomic dysfunction were assessed using a validated instrument, the Composite Autonomic Symptom Scale (COMPASS). The data were compared with an age- and sex-matched cohort of 317 community controls. The relationships between symptoms of dysautonomia and various clinical features of PSS were analysed using regression analysis.
COMPASS scores were significantly higher in patients with PSS than in age- and sex-matched community controls (median (IQR) 35.5 (20.9-46.0) vs 14.8 (4.4-30.2), p<0.0001). Nearly 55% of patients (vs 20% of community controls, p<0.0001) had a COMPASS score >32.5, a cut-off value indicative of autonomic dysfunction. Furthermore, the COMPASS total score correlated independently with EULAR Sjögren's Syndrome Patient Reported Index (a composite measure of the overall burden of symptoms experienced by patients with PSS) (β=0.38, p<0.001) and disease activity measured using the EULAR Sjögren's Syndrome Disease Activity Index (β=0.13, p<0.009).
Autonomic symptoms are common among patients with PSS and may contribute to the overall burden of symptoms and link with systemic disease activity.
确定原发性干燥综合征（PSS）患者自主神经功能障碍（自主神经病变）的患病率，以及自主神经病变与 PSS 其他临床特征之间的关系。
对英国队列中的 317 例具有明确临床特征的 PSS 患者进行了多中心、前瞻性、横断面研究。使用经过验证的自主神经症状综合量表（COMPASS）评估自主神经功能障碍的症状。将数据与年龄和性别匹配的 317 例社区对照组进行比较。使用回归分析分析自主神经病变症状与 PSS 各种临床特征之间的关系。
PSS 患者的 COMPASS 评分明显高于年龄和性别匹配的社区对照组（中位数（IQR）35.5（20.9-46.0）比 14.8（4.4-30.2），p<0.0001）。近 55%的患者（vs 社区对照组的 20%，p<0.0001）的 COMPASS 评分>32.5，这是自主神经功能障碍的截断值。此外，COMPASS 总分与 EULAR 干燥综合征患者报告指数（PSS 患者总体症状负担的综合衡量指标）独立相关（β=0.38，p<0.001），与 EULAR 干燥综合征疾病活动指数（β=0.13，p<0.009）测量的疾病活动相关。
自主神经症状在 PSS 患者中很常见，可能会增加患者的整体症状负担，并与系统性疾病活动相关。
