Manoussakis M N, Pange P J, Moutsopulos H M
Ter Arkh. 1988;60(4):17-20.
The serological profiles of 54 patients clinically diagnosed as pSS and 92 RA patients with or without sSS were retrospectively evaluated and correlated with different SS subgroups, degree of minor salivary gland biopsy lymphocytic infiltrates, and the presence of glandular and extraglandular manifestations. Anti-Ro, anti-La and RF correlated with the development of pSS, while in RA, ANA and anti-Ro were associated with the presence of sSS, and anti-La were practically absent. In pSS patients the incidence of anti Ro and anti-La as well as the titers of ANA and RF correlated with a degree of salivary lymphocytic infiltrates (1+ to 3+). In class 4+ a substantial decrease in autoantibodies was noted. In pSS patients anti-Ro and anti-La correlated with earlier disease onset and longer disease duration, recurrent parotid gland enlargement (RPGE) and extraglandular manifestations, particularly splenomegaly and/or lymphadenopathy and vasculitis. Anti-Ro correlated with positive Schirmer's test, ANA with decreased parotid flow rate and extraglandular manifestations, whereas RF correlated with RPGE and subjective xerostomia. In RA patients autoantibodies were mainly found in the presence of xerophthalmia. ANA correlated with positive Schirmer's test, Rose-Bengal staining and subjective xerophthalmia, the latter also correlated with anti-Ro. This study reemphasized the diagnostic importance of autoantibodies for SS.
对54例临床诊断为原发性干燥综合征(pSS)的患者以及92例有或无继发性干燥综合征(sSS)的类风湿关节炎(RA)患者的血清学特征进行了回顾性评估,并将其与不同的干燥综合征亚组、小唾液腺活检淋巴细胞浸润程度以及腺体和腺外表现的存在情况进行关联分析。抗Ro、抗La和类风湿因子(RF)与pSS的发生相关,而在RA中,抗核抗体(ANA)和抗Ro与sSS的存在相关,抗La几乎不存在。在pSS患者中,抗Ro和抗La的发生率以及ANA和RF的滴度与唾液淋巴细胞浸润程度(1+至3+)相关。在4+级时,自身抗体显著减少。在pSS患者中,抗Ro和抗La与疾病较早发作、较长病程、复发性腮腺肿大(RPGE)和腺外表现相关,尤其是脾肿大和/或淋巴结病以及血管炎。抗Ro与Schirmer试验阳性相关,ANA与腮腺流速降低和腺外表现相关,而RF与RPGE和主观口干相关。在RA患者中,自身抗体主要在存在干眼症时发现。ANA与Schirmer试验阳性、孟加拉玫瑰红染色和主观干眼症相关,主观干眼症也与抗Ro相关。本研究再次强调了自身抗体对干燥综合征的诊断重要性。