Chen Yen-Fu, Hsieh Ao-Ho, Fang Yao-Fan, Kuo Chang-Fu
Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
J Clin Med. 2023 Mar 22;12(6):2428. doi: 10.3390/jcm12062428.
The purpose of this study is to investigate the clinical manifestations in patients with early primary Sjögren's syndrome (pSS) based on the severity score found by salivary gland ultrasonography. Thirty-five newly diagnosed patients with early pSS were enrolled and divided into mild (score 0-1) and severe (score 2-3) groups according to the salivary gland ultrasonography grade (SGUS) scores at baseline. Clinical evaluation, ESSPRI and ESSDAI index values, sicca symptoms of the mouth, salivary capacity, and serum autoantibodies and cytokines were investigated. The mean age of pSS patients at diagnosis was 49.9 ± 11.9 years, and the mean duration of sicca symptoms was 0.58 years. ESSPRI (EULAR Sjögren's syndrome patient report index) and ESSDAI (EULAR Sjögren's syndrome disease index) scores were 15.97 and 4.77, respectively. Clinical manifestations, including the low production of saliva and autoantibody production, such as antinuclear antibodies, rheumatoid factor, and anti-SSA antibody, were found. A higher prevalence of rheumatoid factor ( = 0.0365) and antinuclear antibody ( = 0.0063) and a higher elevation of total IgG ( = 0.0365) were found in the severe group than in the mild group. In addition, the elevated titer of IL-25 was detected in the severe group than in the mild group. This observation indicated that salivary gland ultrasonography grade (SGUS) scans may help physicians diagnose pSS and the elevated titer of IL-25 in patients may be implicated in the pathogenesis of pSS.
本研究的目的是基于唾液腺超声检查得出的严重程度评分，调查早期原发性干燥综合征（pSS）患者的临床表现。纳入35例新诊断的早期pSS患者，并根据基线时唾液腺超声分级（SGUS）评分分为轻度（评分0 - 1）和重度（评分2 - 3）组。对患者进行临床评估、ESSPRI和ESSDAI指数值、口腔干燥症状、唾液分泌能力以及血清自身抗体和细胞因子的检测。pSS患者诊断时的平均年龄为49.9±11.9岁，干燥症状的平均持续时间为0.58年。ESSPRI（欧洲抗风湿病联盟干燥综合征患者报告指数）和ESSDAI（欧洲抗风湿病联盟干燥综合征疾病指数）评分分别为15.97和4.77。发现患者存在包括唾液分泌减少和自身抗体产生（如抗核抗体、类风湿因子和抗SSA抗体）等临床表现。重度组类风湿因子（P = 0.0365）、抗核抗体（P = 0.0063）的患病率以及总IgG升高幅度（P = 0.0365）均高于轻度组。此外，重度组IL - 25的滴度高于轻度组。该观察结果表明，唾液腺超声分级（SGUS）扫描可能有助于医生诊断pSS，且患者IL - 25滴度升高可能与pSS的发病机制有关。
