Nahir A M, Szargel R, Scharf J, Ben-Aryeh H, Laufer D, Scharf Y
B Shine Department of Rheumatology, Rambam Medical Center, Haifa, Israel.
Ann Rheum Dis. 1987 Sep;46(9):654-7. doi: 10.1136/ard.46.9.654.
In some studies, but not in all, abnormally high concentrations of salivary Na+, K+, and IgA have been found in patients with Sjögren's syndrome (SS). The lack of agreement between various reports might be due to the different ways in which saliva was collected. Some analysed stimulated parotid or whole saliva, whereas others used unstimulated saliva. In this study, therefore, the rate of flow and Na+, K+, and IgA levels in unstimulated and stimulated whole saliva in normals and in rheumatoids with and without SS have been determined. The results confirmed significantly raised levels of Na+, K+, and IgA in unstimulated whole saliva in SS. In response to stimulation there was marked decrease in Na+, K+, and IgA levels, whereas normally, as shown by the other two groups, there is an increase in Na+, no change in K+, and a mild decrease in IgA. As a result, the differences between SS and normals became much less significant (K+, IgA) or were even completely obliterated (Na+). The abnormal response of SS to stimulation may be partially explained by the initially low rate of flow and by the extremely high IgA levels. Thus chemical analysis of unstimulated whole saliva is much more sensitive than analysis of stimulated whole saliva in the detection of salivary gland involvement in SS.
在一些研究中（但并非所有研究），已发现干燥综合征（SS）患者唾液中的钠（Na +）、钾（K +）和免疫球蛋白A（IgA）浓度异常升高。不同报告之间缺乏一致性可能是由于唾液采集方式不同。一些研究分析了刺激后的腮腺唾液或全唾液，而其他研究则使用未刺激的唾液。因此，在本研究中，已测定了正常人和患有或未患有SS的类风湿关节炎患者未刺激和刺激后的全唾液流速以及Na +、K +和IgA水平。结果证实，SS患者未刺激全唾液中Na +、K +和IgA水平显著升高。受到刺激后，Na +、K +和IgA水平显著下降，而另外两组显示，正常情况下，Na +会升高，K +无变化，IgA会轻度下降。因此，SS患者与正常人之间的差异变得不那么显著（K +、IgA），甚至完全消失（Na +）。SS对刺激的异常反应可能部分归因于最初的低流速和极高的IgA水平。因此，在检测SS患者的唾液腺受累情况时，未刺激全唾液的化学分析比刺激全唾液的分析更为敏感。
