Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
Clin Exp Rheumatol. 2019 May-Jun;37 Suppl 118(3):146-152. Epub 2019 Jul 22.
In primary Sjögren's syndrome (pSS) dryness of eye and mouth is the cardinal referred symptom. Assessing the rate of activity and damage in the salivary glands of pSS patients is essential to improve disease management. Up to now, a differentiation of activity and damage ultrasonographic (US) lesions is an open issue. The aim of this preliminary study was to identify US lesions which better correlate with loss of function of salivary glands in pSS.
Salivary glands ultrasonography of consecutive patients with established pSS, fulfilling AECG and ACR/EULAR criteria was performed. The association between sialometry and Visual Analogue Scale (VAS) oral dryness and SGUS lesions was assessed trough univariate and multivariate analysis.
In 75 established pSS patients, mean disease duration 12.4±7.2 years, the hyperechoic bands of parotid gland (PG) and submandibular gland (SMG) were significantly associated with sialometry (p<0.001) and VAS oral dryness (PG p=0.002, SMG p<0.001). The global glandular involvement (scored according to De Vita et al., 1992) was associated with sialometry (PG p=0.025, SMG p<0.001) and with VAS oral sicca (PG p=0.015, SMG p<0.001). The multivariate analysis selected the hyperechoic bands of PG and SMG as the variables independently associated with sialometry and the hyperechoic bands and the homogeneity in the SMG as associated with VAS oral dryness.
These results indicate that salivary impairment in pSS, as objectively evaluated by sialometry, could be mainly associated with damage (i.e., hyperechoic bands) in established pSS. Additional follow-up studies and improved scoring tools are needed.
原发性干燥综合征（pSS）的主要特征是眼干和口干。评估 pSS 患者唾液腺的活动度和损伤程度对于改善疾病管理至关重要。到目前为止，区分唾液腺的活动度和损伤超声（US）病变仍是一个悬而未决的问题。本初步研究的目的是确定与 pSS 唾液腺功能丧失相关性更好的 US 病变。
对符合 AECG 和 ACR/EULAR 标准的连续 pSS 患者进行唾液腺超声检查。通过单变量和多变量分析评估唾液流量与视觉模拟量表（VAS）口腔干燥和 SGUS 病变之间的相关性。
在 75 例确诊的 pSS 患者中，平均病程为 12.4±7.2 年，腮腺（PG）和颌下腺（SMG）的高回声带与唾液流量（p<0.001）和 VAS 口腔干燥（PG p=0.002，SMG p<0.001）显著相关。根据 De Vita 等人（1992 年）的评分标准，腺体的整体受累程度与唾液流量（PG p=0.025，SMG p<0.001）和 VAS 口腔干燥（PG p=0.015，SMG p<0.001）相关。多变量分析选择 PG 和 SMG 的高回声带作为与唾液流量独立相关的变量，SMG 的高回声带和均匀性与 VAS 口腔干燥相关。
这些结果表明，pSS 患者的唾液功能障碍，如唾液流量的客观评估，可以主要与已建立的 pSS 中的损伤（即高回声带）相关。需要进一步的随访研究和改进的评分工具。
