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中国人群原发性干燥综合征的临床和实验室特征:315例患者的回顾性分析

Clinical and laboratory profiles of primary Sjogren's syndrome in a Chinese population: A retrospective analysis of 315 patients.

作者信息

Li Xiaomei, Xu Bei, Ma Yan, Li Xiangpei, Cheng Qi, Wang Ximei, Wang Guosheng, Qian Long, Wei Li

机构信息

Department of Rheumatology and Immunology, Anhui Medical University Affiliated Provincial Hospital, Hefei, China.

Department of Rheumatology and Immunology, The Third Affiliated Hospital of Anhui Medical University and the First People' Hospital of Hefei, Hefei, China.

出版信息

Int J Rheum Dis. 2015 May;18(4):439-46. doi: 10.1111/1756-185X.12583. Epub 2015 Apr 30.

Abstract

AIM

To assess the clinical and laboratory features of primary Sjogren's syndrome (pSS) in a large teaching hospital in China.

METHODS

Three hundred and fifteen pSS patients diagnosed according to American-European Classification Criteria and consecutively admitted to Anhui Provincial Hospital from 1 January 1999 to 30 September 2012 were retrospectively selected in this study.

RESULTS

The median age was 46.8 ± 14.4 years (range 13-83 years) and the majority of patients were female (96.5%). The common clinical features at initial presentations were dry mouth (50.2%), dry eyes (31.4%) and joint pain (24.8%); 92.6% of patients had positive anti-SSA antibody and 49.2% patients had positive anti-SSB antibody. One hundred and eighteen patients underwent labial salivary gland biopsy. According to Chisholm grading criteria, grade 3 to 4 was present in 58.5% of the patients. The frequency of interstitial lung disease (ILD) occurred (20.9%) in the patients with systemic extraglandular manifestations. The patients with ILD were frequently associated with positive anti-SSA (P = 0.005) and low levels of C3. The most common impairment of lung function was small airway function abnormalities. Sixty-six pSS patients with ILD (pSS-ILD) were diagnosed with high-resolution computed tomography and treated with corticosteroids and/or immunosuppressants, in which 18 patients had improved pulmonary function.

CONCLUSION

Labial salivary gland biopsy and anti-nuclear antibodies spectrum were important to the diagnosis of pSS. The pSS patients had high percentage of ILD, especially small airway function abnormalities. The combination of corticosteroids and immunosuppressants appears to be effective in treatment of pSS patients with ILD.

摘要

目的

评估中国一家大型教学医院中原发性干燥综合征(pSS)的临床和实验室特征。

方法

本研究回顾性选取了1999年1月1日至2012年9月30日期间,按照欧美分类标准确诊并连续入住安徽省立医院的315例pSS患者。

结果

患者中位年龄为46.8±14.4岁(范围13 - 83岁),大多数患者为女性(96.5%)。初诊时常见的临床特征为口干(50.2%)、眼干(31.4%)和关节疼痛(24.8%);92.6%的患者抗SSA抗体阳性,49.2%的患者抗SSB抗体阳性。118例患者接受了唇腺活检。根据Chisholm分级标准,58.5%的患者为3至4级。有全身腺外表现的患者间质性肺疾病(ILD)发生率为20.9%。ILD患者常伴有抗SSA阳性(P = 0.005)和C3水平降低。最常见的肺功能损害是小气道功能异常。66例pSS合并ILD(pSS-ILD)患者经高分辨率计算机断层扫描确诊,并接受了糖皮质激素和/或免疫抑制剂治疗,其中18例患者肺功能有所改善。

结论

唇腺活检和抗核抗体谱对pSS的诊断很重要。pSS患者ILD发生率较高,尤其是小气道功能异常。糖皮质激素和免疫抑制剂联合使用似乎对治疗pSS合并ILD患者有效。

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