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原发性干燥综合征患者周围神经病变的临床特征及危险因素分析。

Analysis of clinical features and risk factors of peripheral neuropathy in patients with primary Sjögren's syndrome.

机构信息

Department of Rheumatology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Cardiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Eur J Med Res. 2023 Jan 30;28(1):54. doi: 10.1186/s40001-023-01013-w.

Abstract

OBJECTIVE

To observe the clinical features and efficacy of immunosuppressive therapy in patients with primary Sjögren's syndrome (PSS) combined with peripheral neuropathy (PN) syndrome and to explore the risk factors for PN in patients with PSS.

METHODS

Sixty consecutive patients with PSS admitted to the Department of Rheumatology and Immunology, Wuhan No. 1 Hospital, from January 2014 to June 2020 were analysed retrospectively. Patients were divided into a PN group (N = 15) and a non-PN group (N = 45). The clinical characteristics of the two groups were compared, and the independent risk factors for PN combined with PSS were analysed by multivariate logistic regression. The patients with PSS combined with PN were followed up to observe the effect of immunosuppressive therapy.

RESULTS

The patients with PN had a longer course of disease than those without PN (z = - 3.225, P = 0.001), and the incidence of Raynaud's phenomenon, anti-SSB antibody, rheumatoid factor and hyperglobulinaemia was higher (all P < 0.05) in patients with PN than in those without PN. Multivariate logistic regression analysis showed that hyperglobulinaemia, RF and anti-SSB antibodies were independent risk factors for PN with PSS (P < 0.05). Fourteen patients with PSS-PN were treated with immunosuppressants. The clinical symptoms of 10 patients were relieved, and mRS scores of 10 patients were decreased.

CONCLUSION

PN is a common complication in PSS patients. Patients with PSS combined with PN have a longer course of disease and a significantly higher percentage of Raynaud's phenomenon, positive anti-SSB antibody, positive RF and hyperglobulinaemia. Immunosuppressive therapy was effective for partial remission of PN with PSS.

摘要

目的

观察原发性干燥综合征(PSS)合并周围神经病(PN)患者的临床特征和免疫抑制治疗效果,并探讨 PSS 患者发生 PN 的危险因素。

方法

回顾性分析 2014 年 1 月至 2020 年 6 月期间在武汉市第一医院风湿免疫科就诊的 60 例连续 PSS 患者的临床资料。患者分为 PN 组(N=15)和非 PN 组(N=45)。比较两组患者的临床特征,采用多因素 logistic 回归分析 PSS 合并 PN 的独立危险因素。对 PSS 合并 PN 的患者进行随访,观察免疫抑制治疗的效果。

结果

PN 组患者的病程较非 PN 组患者长(z=-3.225,P=0.001),且 PN 组患者发生雷诺现象、抗 SSB 抗体、类风湿因子和高球蛋白血症的比例均高于非 PN 组(均 P<0.05)。多因素 logistic 回归分析显示,高球蛋白血症、RF 和抗 SSB 抗体是 PSS 合并 PN 的独立危险因素(P<0.05)。14 例 PSS-PN 患者接受免疫抑制剂治疗,10 例患者的临床症状缓解,10 例患者的 mRS 评分降低。

结论

PN 是 PSS 患者的常见并发症。PSS 合并 PN 的患者病程较长,发生雷诺现象、抗 SSB 抗体阳性、RF 阳性和高球蛋白血症的比例显著较高。免疫抑制治疗对部分 PSS 合并 PN 患者的缓解有效。

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