Hammenfors Daniel S, Brun Johan G, Jonsson Roland, Jonsson Malin V
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen; and Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.
Department of Rheumatology, Haukeland University Hospital, Bergen; and Department of Clinical Science, Section for Rheumatology, University of Bergen, Norway.
Clin Exp Rheumatol. 2015 Jan-Feb;33(1):56-62. Epub 2014 Dec 22.
To investigate major salivary gland ultrasonography (US) in relation to symptoms and findings of oral and ocular dryness, and autoimmune disease, for potential use in diagnosis and follow-up of patients with primary Sjögren's syndrome (pSS).
Patients with pSS were recruited from the Department of Rheumatology, Haukeland University Hospital. The parotid and submandibular salivary glands were examined by US using a simplified scoring system for glandular homogeneity and hypoechogenic areas. Scans were graded on a scale 0-3, grades 0-1 considered corresponding to normal/non-specific changes and grades 2-3 to pathological changes. Sicca symptoms of the mouth and eyes, salivary gland capacity, tear secretion, minor salivary gland inflammation, serum autoantibodies, and fatigue were also investigated.
US was performed in 97 patients. Oral and ocular sicca symptoms correlated with US score and decreased saliva levels. Fatigue VAS correlated with oral sicca symptoms but was inversely correlated with age. Patients with normal/non-specific US findings tended to be older than patients with pathological US findings. US score correlated with unstimulated and stimulated salivary secretion and tear secretion. Minor salivary gland inflammation correlated with major salivary gland US findings, and lymphoid organisation, germinal centre (GC)-like structures, in the minor salivary gland tissue biopsies was seemingly related to US pathology. Serum autoantibodies against Ro/SSA and/or La/SSB were associated with US pathology.
US findings in major salivary glands correlate with subjective and objective oral and ocular items as well as systemic autoimmune features of pSS. US represents a useful imaging tool for diagnostics and follow-up of pSS.
研究大唾液腺超声检查（US）与口腔和眼部干燥症状、体征以及自身免疫性疾病的关系，探讨其在原发性干燥综合征（pSS）患者诊断及随访中的潜在应用价值。
从豪克兰大学医院风湿病科招募pSS患者。采用简化评分系统对腮腺和颌下唾液腺进行超声检查，评估腺体均匀性和低回声区。扫描结果按0 - 3级评分，0 - 1级视为正常/非特异性改变，2 - 3级为病理性改变。同时调查口腔和眼部的干燥症状、唾液腺功能、泪液分泌、小唾液腺炎症、血清自身抗体及疲劳情况。
对97例患者进行了超声检查。口腔和眼部干燥症状与超声评分及唾液水平降低相关。疲劳视觉模拟评分（VAS）与口腔干燥症状相关，但与年龄呈负相关。超声检查结果正常/非特异性的患者往往比有病理改变的患者年龄大。超声评分与非刺激性和刺激性唾液分泌及泪液分泌相关。小唾液腺炎症与大唾液腺超声检查结果相关，小唾液腺组织活检中的淋巴组织、生发中心（GC）样结构似乎与超声病理相关。抗Ro/SSA和/或La/SSB血清自身抗体与超声病理相关。
大唾液腺超声检查结果与pSS患者的主观和客观口腔及眼部指标以及全身自身免疫特征相关。超声是pSS诊断和随访的一种有用的影像学工具。
