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干燥综合征累及唾液腺的唾液腺内镜检查:一项随机对照试验性研究

Sialendoscopy of Salivary Glands Affected by Sjögren Syndrome: A Randomized Controlled Pilot Study.

作者信息

Jager Derk Jan, Karagozoglu K Hakki, Maarse Floor, Brand Henk S, Forouzanfar Tim

机构信息

Assistant Professor, Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam; Center for Special Care Dentistry (Stichting Bijzondere Tandheelkunde), Amsterdam, The Netherlands.

Maxillofacial Surgeon and PhD Candidate, Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

J Oral Maxillofac Surg. 2016 Jun;74(6):1167-74. doi: 10.1016/j.joms.2015.12.019. Epub 2016 Jan 7.

Abstract

PURPOSE

Sialendoscopy of the major salivary glands could alleviate the oral symptoms of Sjögren syndrome (SS) and restore salivary function. The aim of this pilot study was to evaluate the effect of sialendoscopy of the major salivary glands on salivary flow, saliva composition, and mouthfeel in patients with SS and to collect data for sample size analysis for a larger clinical trial.

MATERIALS AND METHODS

Twenty patients diagnosed with SS were randomly assigned to a nonintervention control group or a sialendoscopy group. Unstimulated whole saliva flow, stimulated whole saliva flow, Clinical Oral Dryness Score, Xerostomia Inventory score, and EULAR Sjögren's Syndrome Patient Reported Index score were obtained 1 week before (T0), 1 week after (T2), and 8 weeks after (T3) sialendoscopy. Unstimulated whole saliva was analyzed for amylase concentration, activity, and mucin 5B concentration. Amylase and mucin 5B output were calculated.

RESULTS

In the sialendoscopy group, unstimulated and stimulated whole saliva flows were numerically higher at T2 and T3 compared with T0. Xerostomia Inventory score was significantly lower in the sialendoscopy group at T2 compared with T0 (P = .03). Unstimulated and stimulated whole saliva flows were higher in the sialendoscopy group compared with the control group at T2 and T3 (not meaningful). Significant differences were found between groups for the EULAR Sjögren's Syndrome Patient Reported Index score at T2 (P = .03) and T3 (P = .001). Xerostomia Inventory score and Clinical Oral Dryness Score in the sialendoscopy group were lower compared with the control group at T2 (P = .02) and at T3 (P = .04), indicating less oral dryness.

CONCLUSION

This pilot study indicates a positive effect of sialendoscopy on some parameters, but it cannot yet be concluded that it has a positive effect on salivary flow in patients with SS. These preliminary results need to be verified in a randomized controlled trial with a larger sample and longer follow-up period.

摘要

目的

大唾液腺涎腺内镜检查可缓解干燥综合征(SS)的口腔症状并恢复唾液功能。本前瞻性研究的目的是评估大唾液腺涎腺内镜检查对SS患者唾液流量、唾液成分和口感的影响,并收集数据以进行更大规模临床试验的样本量分析。

材料与方法

20例诊断为SS的患者被随机分为非干预对照组或涎腺内镜检查组。在涎腺内镜检查前1周(T0)、检查后1周(T2)和检查后8周(T3)获取非刺激性全唾液流量、刺激性全唾液流量、临床口腔干燥评分、口干症量表评分和欧洲抗风湿病联盟干燥综合征患者报告指数评分。分析非刺激性全唾液的淀粉酶浓度、活性和黏蛋白5B浓度。计算淀粉酶和黏蛋白5B的分泌量。

结果

在涎腺内镜检查组中,与T0相比,T2和T3时非刺激性和刺激性全唾液流量在数值上更高。与T0相比,涎腺内镜检查组在T2时的口干症量表评分显著降低(P = .03)。在T2和T3时,涎腺内镜检查组的非刺激性和刺激性全唾液流量高于对照组(无统计学意义)。两组在T2(P = .03)和T3(P = .001)时的欧洲抗风湿病联盟干燥综合征患者报告指数评分存在显著差异。与对照组相比,涎腺内镜检查组在T2(P = .02)和T3(P = .04)时的口干症量表评分和临床口腔干燥评分更低,表明口腔干燥程度较轻。

结论

本前瞻性研究表明涎腺内镜检查对某些参数有积极影响,但尚不能得出其对SS患者唾液流量有积极影响的结论。这些初步结果需要在更大样本量和更长随访期的随机对照试验中得到验证。

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