Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Ann Rheum Dis. 2018 Jul;77(7):1025-1031. doi: 10.1136/annrheumdis-2017-212672. Epub 2018 Feb 23.
To assess the effect of sialendoscopy of the major salivary glands on salivary flow and xerostomia in patients with Sjögren's syndrome (SS).
Forty-nine patients with SS were randomly assigned to a control group (n=15) and two intervention groups: irrigation of the major glands with saline (n=16) or with saline followed by triamcinolone acetonide (TA) in saline (n=18). Unstimulated whole saliva flow (UWS), chewing-stimulated whole saliva flow (SWS), citric acid-stimulated parotid flow (SPF), Clinical Oral Dryness Score (CODS), Xerostomia Inventory (XI) score and the European League Against Rheumatism (EULAR) SS Patient-Reported Index (ESSPRI) were obtained 1 week (T0) before, and 1 (T1), 8 (T8), 16 (T16) and 24 (T24) weeks after sialendoscopy.
Median baseline UWS, SWS and SPF scores were 0.14, 0.46 and 0.22 mL/min, respectively. After intervention, significant increases in UWS and SWS were observed in the saline group (at T8 (P=0.013) and T24 (P=0.004)) and the saline/TA group (at T24 (P=0.03) and T=16 (P=0.035)). SPF was increased significantly in the saline/TA group at T24 (P=0.03). XI scores declined after sialendoscopy in both intervention groups. Compared with the control group, CODS, XI and ESSPRI improved in the intervention groups. UWS, SWS and SPF were higher in the intervention groups compared with the control group, but these differences were not significant except for SPF in the saline/TA group at T24 (P=0.005).
Irrigation of the major salivary glands in patients with SS enhances salivary flow and reduces xerostomia up to 6 months after sialendoscopy.
评估涎腺内镜术对干燥综合征（SS）患者唾液流率和口干的影响。
将 49 例 SS 患者随机分为对照组（n=15）和 2 个干预组：腺体灌洗盐水（n=16）或盐水加曲安奈德（TA）（n=18）。分别在术前 1 周（T0）、术后 1 周（T1）、8 周（T8）、16 周（T16）和 24 周（T24）测量未刺激全唾液流率（UWS）、咀嚼刺激全唾液流率（SWS）、柠檬酸刺激腮腺流率（SPF）、临床口腔干燥评分（CODS）、口干量表（XI）评分和欧洲抗风湿病联盟（EULAR）干燥综合征患者报告指数（ESSPRI）。
基线 UWS、SWS 和 SPF 中位数分别为 0.14、0.46 和 0.22ml/min。干预后，盐水组 UWS 和 SWS 在 T8（P=0.013）和 T24（P=0.004）时显著增加，盐水/TA 组在 T24（P=0.03）和 T16（P=0.035）时显著增加。SPF 在 T24 时盐水/TA 组也显著增加（P=0.03）。在两组干预后，XI 评分均下降。与对照组相比，干预组 CODS、XI 和 ESSPRI 改善。与对照组相比，干预组 UWS、SWS 和 SPF 较高，但除盐水/TA 组在 T24 时 SPF 外（P=0.005），差异无统计学意义。
在 SS 患者中，对主要唾液腺进行灌洗可增加唾液流率并在涎腺内镜术后 6 个月内减轻口干。
