Vitali C, Giuggioli C, Monti P, Rossi G, Wu D H, d'Ascanio A, Chiellini S, Gabriele M, Bombardieri S
Rheumatic Disease Unit, University of Pisa, Italy.
Clin Exp Rheumatol. 1989 Mar-Apr;7(2):191-5.
The potential value for the diagnosis of Sjögren's syndrome (SS) of 28 clinical and 18 serological parameters was evaluated in 38 patients with primary (1 degree) SS, 29 with rheumatoid arthritis (RA), 30 with systemic lupus erythematosus (SLE), and 22 with mixed cryoglobulinemia (MC), by means of a stepwise discriminant analysis. Twelve patients with RA, 11 with SLE, and 8 with MC had evidence of sicca syndrome and were then classified as having a secondary (2 degree) SS. When comparing the various disease groups to each other, it was always possible to select different combinations of clinical and serological variables which defined highly significant discriminant functions. In addition, some parameters appeared to have a stronger discriminant power between different disease groups. For instance, 1 degree SS was well discriminated from RA by anti-Ro antibodies (Ab) and normal C-reactive protein (CRP) levels, from SLE by normal complement levels and the positivity of rheumatoid factor, from MC by the absence of liver involvement and normal complement levels. While anti-La Ab had the highest value in differentiating patients with 1 degree from those with 2 degrees SS, anti-Ro Ab and recurrent parotid swelling seem to be typical features of patients with SS with respect to those with other connective tissue disease but without sicca syndrome.
通过逐步判别分析，对38例原发性（1级）干燥综合征（SS）患者、29例类风湿关节炎（RA）患者、30例系统性红斑狼疮（SLE）患者和22例混合性冷球蛋白血症（MC）患者的28项临床参数和18项血清学参数在诊断SS方面的潜在价值进行了评估。12例RA患者、11例SLE患者和8例MC患者有干燥综合征的证据，随后被归类为继发性（2级）SS。在将不同疾病组相互比较时，总是可以选择不同的临床和血清学变量组合，这些组合定义了高度显著的判别函数。此外，一些参数在不同疾病组之间似乎具有更强的判别能力。例如，1级SS通过抗Ro抗体（Ab）和正常C反应蛋白（CRP）水平与RA很好地区分，通过正常补体水平和类风湿因子阳性与SLE区分，通过无肝脏受累和正常补体水平与MC区分。虽然抗La Ab在区分1级和2级SS患者方面价值最高，但抗Ro Ab和复发性腮腺肿胀似乎是SS患者相对于其他无干燥综合征的结缔组织疾病患者的典型特征。
