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原发性干燥综合征患者的跨学科、全面口腔和眼部评估。

Interdisciplinary, Comprehensive Oral and Ocular Evaluation of Patients with Primary Sjögren's Syndrome.

机构信息

Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.

The Norwegian Dry Eye Clinic, Oslo, Norway.

出版信息

Sci Rep. 2017 Sep 7;7(1):10761. doi: 10.1038/s41598-017-10809-w.

Abstract

A comprehensive evaluation of oral and ocular symptoms and findings in primary Sjögren's syndrome (pSS) patients may provide valuable information for management. Medical history was obtained from female pSS patients, and sex- and age-matched non-SS patients with sicca symptoms (non-SS sicca controls) as well as healthy subjects without sicca complaints (healthy controls). Oral (Summated Xerostomia Inventory, SXI) and ocular (McMonnies Dry Eye questionnaire, MDEIS, and Ocular Surface Disease Index, OSDI) subjective complaints were recorded. Objective findings including clinical oral dryness scores (CODS), unstimulated and stimulated saliva secretion rates (UWS/SWS), Schirmer I test, tear osmolarity, tear film break-up time (TFBUT), and ocular surface staining (OSS) were determined. The pSS and non-SS sicca controls were extensively troubled by subjective dryness, while the pSS group had higher CODS, significantly lower saliva and tear secretion, shorter TFBUT and higher OSS than both control groups. Furthermore, candida counts were significantly higher in the pSS patients. In the pSS group, subjective oral dryness significantly correlated with ocular dryness (MDEIS: r = 0.5, OSDI: r = 0.413) and SWS was significantly correlated with Schirmer I (r = 0.419). The findings imply that interdisciplinary subjective and objective evaluation of patients with xerostomia and xerophthalmia not only have implications for patient care, but also may guide clinicians in differentiating between pSS and non-SS sicca patients.

摘要

对原发性干燥综合征 (pSS) 患者的口腔和眼部症状及发现进行全面评估可为其治疗提供有价值的信息。我们收集了女性 pSS 患者的病史,并与有干燥症状的性别和年龄匹配的非 SS 患者(非 SS 干燥对照组)以及无干燥症状的健康受试者(健康对照组)进行了比较。记录了口腔(口干综合评估量表,SXI)和眼部(McMonnies 干眼问卷,MDEIS 和眼表疾病指数,OSDI)的主观症状。还确定了客观检查结果,包括临床口腔干燥评分(CODS)、非刺激和刺激唾液分泌率(UWS/SWS)、Schirmer I 试验、泪液渗透压、泪膜破裂时间(TFBUT)和眼表面染色(OSS)。pSS 和非 SS 干燥对照组的患者均受到严重的主观干燥困扰,而 pSS 组的 CODS 更高,唾液和泪液分泌明显减少,泪膜破裂时间更短,眼表面染色评分更高。此外,pSS 患者的白色念珠菌计数明显更高。在 pSS 组中,口腔干燥的主观症状与眼部干燥显著相关(MDEIS:r=0.5,OSDI:r=0.413),而 SWS 与 Schirmer I 呈显著相关(r=0.419)。这些发现表明,对口干和眼干患者进行跨学科的主观和客观评估不仅对患者护理具有重要意义,而且可能有助于临床医生区分 pSS 和非 SS 干燥患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95e0/5589846/8a64838fa568/41598_2017_10809_Fig1_HTML.jpg

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