Farenhorst Claudette A, de Wolff Liseth, Arends Suzanne, van Nimwegen Jolien F, Kroese Frans Gerardus Maria, Verstappen Gwenny M, Bootsma Hendrika
Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, the Netherlands.
Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, The Netherlands.
Clin Exp Rheumatol. 2021 Nov-Dec;39 Suppl 133(6):73-79. doi: 10.55563/clinexprheumatol/hzveng. Epub 2021 Oct 7.
The majority of women with primary Sjögren's syndrome (pSS) suffer from vaginal dryness, which negatively impacts daily and sexual activities. As little is known about the aetiology and clinical context of this complaint, this study investigated the relationship between vaginal dryness and other clinical parameters associated with pSS.
Female participants of the REgistry of Sjögren syndrome at UMCG - LongiTudinal (RESULT) cohort who fulfilled ACR-EULAR and/or AECG classification criteria for pSS were included, using baseline data for analyses. Patient-reported vaginal dryness (range 0-10) was correlated with demographic characteristics, systemic disease activity (i.e., ESSDAI), Sjögren's Syndrome Disease Damage Index, salivary and lacrimal gland function, patient-reported outcomes (ESSPRI, MFI), serology and quality of life (SF-36, EQ-5D). Significantly associated parameters (p<0.05) were corrected for potential confounders.
This cross-sectional study included 199 women with pSS; mean age was 52±14 years, 53% were postmenopausal, and median vaginal dryness score was 5 (IQR 2-7). Vaginal dryness was significantly associated with older age, postmenopausal status, peripheral neuropathy, oral and ocular dryness, ESSPRI and SF-36 mental and general health. After correction for age, menopausal status and medication use, peripheral neuropathy (B=1.632), oral dryness (B=0.302), and ocular dryness (B=0.230) were independently associated with vaginal dryness.
The independent association of vaginal dryness with oral and ocular dryness might imply that the aetiology of these symptoms is partly shared. Of all extraglandular features, only peripheral neuropathy was independently associated with vaginal dryness, suggesting that peripheral neuropathy plays a significant role in the pathology of vaginal dryness in pSS.
大多数原发性干燥综合征（pSS）女性患者存在阴道干燥问题，这对日常活动和性活动产生负面影响。由于对该症状的病因和临床背景了解甚少，本研究调查了阴道干燥与pSS相关的其他临床参数之间的关系。
纳入了荷兰格罗宁根大学医学中心纵向干燥综合征注册研究（RESULT）队列中符合美国风湿病学会（ACR）-欧洲抗风湿病联盟（EULAR）和/或美国欧洲临床免疫学会（AECG）pSS分类标准的女性参与者，使用基线数据进行分析。患者报告的阴道干燥程度（范围0-10）与人口统计学特征、全身疾病活动度（即欧洲干燥综合征疾病活动指数[ESSDAI]）、干燥综合征疾病损伤指数、唾液和泪腺功能、患者报告结局（欧洲干燥综合征患者报告指数[ESSPRI]、多维疲劳量表[MFI]）、血清学及生活质量（36项简短健康调查[SF-36]、欧洲五维度健康量表[EQ-5D]）进行相关性分析。对显著相关的参数（p<0.05）校正潜在混杂因素。
这项横断面研究纳入了199例pSS女性患者；平均年龄为52±1岁，53%为绝经后女性，阴道干燥程度中位数为5（四分位间距2-7）。阴道干燥与年龄较大、绝经后状态、周围神经病变、口腔和眼部干燥、ESSPRI以及SF-36精神和总体健康显著相关。在校正年龄、绝经状态和药物使用后，周围神经病变（B=1.632）、口腔干燥（B=0.302）和眼部干燥（B=0.230）与阴道干燥独立相关。
阴道干燥与口腔和眼部干燥的独立关联可能意味着这些症状的病因部分相同。在所有腺外表现中，只有周围神经病变与阴道干燥独立相关，提示周围神经病变在pSS阴道干燥的病理过程中起重要作用。
