干燥综合征的流行病学。
The epidemiology of Sjögren's syndrome.
机构信息
Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
Clin Epidemiol. 2014 Jul 30;6:247-55. doi: 10.2147/CLEP.S47399. eCollection 2014.
Sjögren's syndrome is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of exocrine glands. It can present as an entity by itself, primary Sjögren's syndrome (pSS), or in addition to another autoimmune disease, secondary Sjögren's syndrome (sSS). pSS has a strong female propensity and is more prevalent in Caucasian women, with the mean age of onset usually in the 4th to 5th decade. Clinical presentation varies from mild symptoms, such as classic sicca symptoms of dry eyes and dry mouth, keratoconjunctivitis sicca, and xerostomia, to severe systemic symptoms, involving multiple organ systems. Furthermore, a range of autoantibodies can be present in Sjögren's syndrome (anti-SSA/Ro and anti-SSB/La antibodies, rheumatoid factor, cryoglobulins, antinuclear antibodies), complicating the presentation. The heterogeneity of signs and symptoms has led to the development of multiple classification criteria. However, there is no accepted universal classification criterion for the diagnosis of Sjögren's syndrome. There are a limited number of studies that have been published on the epidemiology of Sjögren's syndrome, and the incidence and prevalence of the disease varies according to the classification criteria used. The data is further confounded by selection bias and misclassification bias, making it difficult for interpretation. The aim of this review is to understand the reported incidence and prevalence on pSS and sSS, the frequency of autoantibodies, and the risk of malignancy, which has been associated with pSS, taking into account the different classification criteria used.
干燥综合征是一种慢性系统性自身免疫性疾病,其特征为外分泌腺的淋巴细胞浸润。它可以作为一个独立的实体出现,即原发性干燥综合征(pSS),也可以与另一种自身免疫性疾病同时出现,即继发性干燥综合征(sSS)。pSS 具有强烈的女性倾向,在白种人群中更为常见,发病的平均年龄通常在 40 到 50 岁之间。临床表现从轻度症状,如典型的干燥眼和口干症状、干燥性角结膜炎和口干,到严重的全身症状,涉及多个器官系统。此外,干燥综合征中还可以存在一系列自身抗体(抗 SSA/Ro 和抗 SSB/La 抗体、类风湿因子、冷球蛋白、抗核抗体),使病情复杂化。症状和体征的异质性导致了多种分类标准的发展。然而,目前还没有被普遍接受的用于干燥综合征诊断的通用分类标准。关于干燥综合征的流行病学,仅有少量研究发表,而且根据所使用的分类标准,疾病的发病率和患病率有所不同。数据进一步受到选择偏倚和分类偏倚的影响,使得解释变得困难。本综述的目的是了解报道的 pSS 和 sSS 的发病率和患病率、自身抗体的频率以及与 pSS 相关的恶性肿瘤风险,同时考虑到所使用的不同分类标准。