根据2016年美国风湿病学会（ACR）和欧洲抗风湿病联盟（EULAR）分类标准，系统性红斑狼疮患者中干燥综合征的患病率
Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus.
作者信息
Gianordoli Ana Paula Espíndula, Laguardia Rafaella Vila Real Barbosa, Santos Maria Carmen F S, Jorge Fabiano Cade, da Silva Salomão Amanda, Caser Larissa Carvalho, Moulaz Isac Ribeiro, Serrano Érica Vieira, Miyamoto Samira Tatiyama, Machado Ketty Lysie Libardi Lira, Valim Valéria
机构信息
Rheumatology Division, University Hospital Cassiano Antônio Moraes of Federal University of Espírito Santo (HUCAM-UFES/EBSERH), Mal. Campos Avenue, n° 1355, Santos Dumont, Vitória, ES, 29041-295, Brazil.
Federal University of Espírito Santo, Vitória, ES, Brazil.
出版信息
Adv Rheumatol. 2023 Mar 14;63(1):11. doi: 10.1186/s42358-022-00280-1.
BACKGROUND
Diagnosis of SS is a complex task, as no symptom or test is unique to this syndrome. The American-European Consensus Group (AECG 2002) and the American-European classification criteria of 2016 (ACR/EULAR 2016) emerged through a search for consensus. This study aims to assess the prevalence of Sjögren's Syndrome (SS) in patients with Systemic Lupus Erythematosus (SLE), according to AECG 2002 and ACR-EULAR 2016 classifications, as well as clinical and histopathological features in this overlap. To date, there is no study that has evaluated SS in SLE, using the two current criteria.
METHODS
This cross-sectional study evaluated 237 SLE patients at the outpatient rheumatology clinic between 2016 and 2018. Patients were submitted to a dryness questionnaire, whole unstimulated salivary flow (WUSF), "Ocular Staining Score" (OSS), Schirmer's test I (ST-I), and labial salivary gland biopsy (LSGB).
RESULTS
After verifying inclusion and exclusion criteria, a total of 117 patients were evaluated, with predominance of females (94%) and mixed ethnicity (49.6%). The prevalence of SS was 23% according to AECG 2002 and 35% to ACR-EULAR 2016. Kappa agreement between AECG 2002 and ACR-EULAR 2016 were 0.7 (p < 0.0001). After logistic regression, predictors for SS were: anti/Ro (OR = 17.86, p < 0.05), focal lymphocytic sialadenitis (OR = 3.69, p < 0.05), OSS ≥ 5 (OR = 7.50, p < 0.05), ST I positive (OR = 2.67, p < 0.05), and WUSF ≤ 0.1 mL/min (OR = 4.13, p < 0.05).
CONCLUSION
The prevalence of SS in SLE was 23% (AECG 2002) and 35% (ACR-EULAR 2016). The presence of glandular dysfunction, focal lymphocytic sialadenitis, and anti/Ro were predictors of SS in SLE. The greatest advantage of the new ACR-EULAR 2016 criteria is to enable an early diagnosis and identify the overlapping of these two diseases. ACR-EULAR 2016 criteria is not yet validated for secondary SS and this study is a pioneer in investigating prevalence based on the new criteria.
背景
干燥综合征（SS）的诊断是一项复杂的任务，因为没有任何症状或检查对该综合征具有特异性。美国-欧洲共识小组（AECG 2002）和2016年美国-欧洲分类标准（ACR/EULAR 2016）是通过寻求共识而产生的。本研究旨在根据AECG 2002和ACR-EULAR 2016分类评估系统性红斑狼疮（SLE）患者中干燥综合征（SS）的患病率，以及这种重叠情况的临床和组织病理学特征。迄今为止，尚无研究使用这两种现行标准评估SLE中的SS。
方法
这项横断面研究在2016年至2018年期间对门诊风湿病诊所的237例SLE患者进行了评估。患者接受了干燥问卷、全唾液非刺激性流量（WUSF）、“眼表染色评分”（OSS）、Schirmer试验I（ST-I）和唇唾液腺活检（LSGB）。
结果
在核实纳入和排除标准后，共评估了117例患者，以女性为主（94%），种族混合（49.6%）。根据AECG 2002，SS的患病率为23%，根据ACR-EULAR 2016为35%。AECG 2002与ACR-EULAR 2016之间的kappa一致性为0.7（p < 0.0001）。经过逻辑回归分析，SS的预测因素为：抗Ro（OR = 17.86，p < 0.05）、局灶性淋巴细胞性涎腺炎（OR = 3.69，p < 0.05）、OSS≥5（OR = 7.50，p < （此处原文有误，应是p < 0.05））、ST I阳性（OR = 2.67，p < 0.05）和WUSF≤0.1 mL/min（OR = 4.13，p < 0.05）。
结论
SLE中SS的患病率为23%（AECG 2002）和35%（ACR-EULAR 2016）。腺体功能障碍、局灶性淋巴细胞性涎腺炎和抗Ro的存在是SLE中SS的预测因素。新的ACR-EULAR 2016标准的最大优势是能够进行早期诊断并识别这两种疾病之间的重叠。ACR-EULAR 2016标准尚未在继发性SS中得到验证，本研究是基于新标准调查患病率的先驱。
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