Daniels T E
School of Dentistry, University of California, San Francisco 94143-0424.
J Autoimmun. 1989 Aug;2(4):529-41. doi: 10.1016/0896-8411(89)90186-8.
Because salivary gland function and morphology can be changed by a variety of diseases and drugs, the process of clinically assessing and diagnosing salivary gland changes in patients suspected of having Sjögren's syndrome (SS) must include not just clinical recognition of the problem and assessment of its nature and severity, but identification of the cause. Determining the presence of the salivary component of SS in a patient suspected of having the disease involves three types of observations: (1) eliciting symptoms and observing signs suggesting decreased salivary function (xerostomia) during the examination, (2) objectively assessing functional or anatomical salivary changes with different types of clinical procedures that are not necessarily disease-specific, and (3) applying the most disease-specific procedures as diagnostic criteria to determine the cause of the problem. Currently used diagnostic criteria for the salivary component of SS are reviewed and compared. Alternative diagnostic criteria should be avoided if they substitute non-specific tests for more disease-specific tests. There is as yet no perfect diagnostic criterion for the salivary component of SS, but significant focal sialadenitis in a labial salivary gland biopsy is the best in terms of its disease specificity, convenience, availability and low risk.
由于多种疾病和药物会改变唾液腺的功能和形态，因此，对疑似患有干燥综合征（SS）患者的唾液腺变化进行临床评估和诊断的过程，不仅必须包括对问题的临床识别以及对其性质和严重程度的评估，还包括病因的确定。在疑似患有该病的患者中确定SS唾液成分的存在涉及三种观察：（1）在检查过程中引出症状并观察提示唾液功能下降（口干症）的体征；（2）使用不一定针对特定疾病的不同类型临床程序客观评估功能性或解剖学上的唾液变化；（3）应用最具疾病特异性的程序作为诊断标准来确定问题的原因。本文对目前使用的SS唾液成分诊断标准进行了综述和比较。如果替代诊断标准用非特异性检查替代了更具疾病特异性的检查，则应避免使用。目前尚无针对SS唾液成分的完美诊断标准，但就疾病特异性、便利性、可及性和低风险而言，唇腺活检中显著的局灶性涎腺炎是最佳的。
