Luo Jing, Xu Shihao, Lv Yinqiu, Huang Xinshi, Zhang Huxiang, Zhu Xiaochun, Wang Xiaobing
Rheumatology Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Int J Rheum Dis. 2019 Feb;22(2):182-190. doi: 10.1111/1756-185X.13429. Epub 2018 Nov 8.
To investigate distinct features of renal involvement in patients with primary Sjögren's syndrome (pSS) and to identify potential factors associated with renal involvement.
Four hundred and thrity-four pSS patients from the Rheumatology Department of the First Affiliated Hospital of Wenzhou Medical University from 2013 to 2017 were included in a cross-sectional study. Patients with renal involvement were compared with their age- and gender-matched controls (pSS without renal involvement). Demographic, clinical, histological, nephritic, immunological features of renal involvement in pSS were systematically analyzed. Possible factors related to renal involvement were identified using multivariate logistic regression analyses.
One hundred and ninety-two pSS patients (88.48%) with renal involvement were women with mean age of nearly 58 years and mean disease duration of above 4 years. Clinical manifestation, serologic and immunological features and renal biopsy class of the pSS patients with renal involvement were presented. By multivariate analyses, xerophthalmia, histological positivity for lower salivary gland biopsy (LSGB), anti-SSA/Ro52-positive, reduced complement 3 (C3) levels, hypoalbuminemia and anemia retained significant association with renal involvement in pSS (all P < 0.05).
In addition to LSGB pattern, anti-SSA/Ro52-positivity, reduced C3 levels, hypoalbuminemia and anemia, also indicate significant association with renal involvement in pSS. Therefore, early vigilance is required for patients with these clinical manifestations.
探讨原发性干燥综合征(pSS)患者肾脏受累的独特特征,并确定与肾脏受累相关的潜在因素。
纳入2013年至2017年温州医科大学附属第一医院风湿科的434例pSS患者进行横断面研究。将肾脏受累患者与其年龄和性别匹配的对照组(无肾脏受累的pSS患者)进行比较。系统分析pSS患者肾脏受累的人口统计学、临床、组织学、肾炎和免疫学特征。使用多因素逻辑回归分析确定与肾脏受累相关的可能因素。
192例(88.48%)肾脏受累的pSS患者为女性,平均年龄近58岁,平均病程4年以上。呈现了肾脏受累的pSS患者的临床表现、血清学和免疫学特征以及肾活检分类。通过多因素分析,干眼症、下颌下腺活检(LSGB)组织学阳性、抗SSA/Ro52阳性、补体3(C3)水平降低、低白蛋白血症和贫血与pSS患者的肾脏受累仍有显著关联(均P<0.05)。
除了LSGB模式、抗SSA/Ro52阳性、C3水平降低、低白蛋白血症和贫血外,还表明与pSS患者的肾脏受累有显著关联。因此,对于有这些临床表现的患者需要早期警惕。