干燥综合征患者的非刺激全唾液流率：系统文献回顾和荟萃分析。

Unstimulated whole salivary flow in Sjögren's Syndrome: systematic literature review and meta-analysis.

机构信息

Research Division Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.

Internal Medicine Department, Fundación Universitaria de Ciencias de la Salud (FUCS). Hospital San José, Bogotá, Colombia.

出版信息

Adv Rheumatol. 2021 Feb 3;61(1):8. doi: 10.1186/s42358-020-00158-0.

DOI:10.1186/s42358-020-00158-0

PMID:33536075

Abstract

BACKGROUND

Sjögren's Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren's versus healthy people or patients with non-Sjögren's sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren's syndrome in comparison to controls (healthy and non-Sjögren's sicca patients).

METHODS

A systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively.

RESULTS

Thirty-two articles were included (20 were case-control studies, 6 were cross-sectional, 2 prospective cohort, 2 retrospective cohort, and 2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren's group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, - 0.24 to - 0.13; chi-P-value < 0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly 3 or 4. The quality of evidence was met (97% of items valued).

CONCLUSION

For the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren's syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis.

TRIAL REGISTRATION

PROSPERO CRD42020211325 .

摘要

背景

干燥综合征会影响外分泌功能，导致口干和眼干。它可以作为一种孤立的病症出现，也可以与其他自身免疫性疾病（多自身免疫）相关联。非刺激性唾液流量（UWSF）用于定量唾液产生。目前还没有客观证据可以区分干燥综合征患者与健康人或非干燥综合征干燥患者的 UWSF 值。本综述的目的是评估干燥综合征患者的 UWSF 与对照组（健康人和非干燥综合征干燥患者）的差异。

方法

进行了系统的文献综述（PRISMA 指南）。纳入了病例对照研究、横断面研究、队列研究和随机临床试验（包括健康对照组）的分析观察性研究。检索了 Medline/OVID、Lilacs、Embase 和 Cochrane/OVID 数据库。使用了 MeSH、DeCS、关键词和布尔运算符。通过随机效应模型[平均差异（MD）]进行了荟萃分析（RevMan 5.2）。使用牛津证据等级和 Joanna Brigs 清单分别评估了证据水平和质量。

结果

纳入了 32 篇文章（20 篇为病例对照研究，6 篇为横断面研究，2 篇为前瞻性队列研究，2 篇为回顾性队列研究，2 篇为摘要），并对 28 篇进行了荟萃分析。干燥综合征组的非刺激性全唾液流量低于对照组（健康人和非干燥综合征干燥患者）（MD-0.18ml/min；95%CI：-0.24 至-0.13；chi-P 值<0.00001）。异质性为 97%，存在发表偏倚（漏斗图）。证据水平大多为 3 或 4 级。证据质量符合要求（97%的项目赋值）。