在病程较长的原发性干燥综合征患者中，超声检查发现的唾液腺实质病变是否更严重？一项横断面研究。

Are ultrasound salivary parenchymal lesions more severe in primary Sjögren patients with a longer disease duration? A cross-sectional study.

作者信息

Tison Alice, Jousse-Joulin Sandrine, Consigny Maëlys, Moog Philipp, Hofauer Benedikt, Hachulla Eric, Lamotte Christophe, Morel Jacques, Mouterde Gaël, Milic Vera, Bootsma Hendrika, Stel Alja, Fisher Benjamin A, Maybury Marc, Baer Alan, DiRenzo Dana, Kim Hae-Rim, Min Hong-Ki, Lee Shin-Seok, Choi Sung-Eun, Carvajal Alegria Guillermo, Boisramé Sylvie, Guellec Dewi, Cornec Divi, Quéré Baptiste, Jonsson Malin, Hammenfors Daniel, Saraux Alain, Devauchelle-Pensec Valérie

机构信息

Department of Rheumatology, CHU Brest, Université de Bretagne Occidentale (Univ Brest), INSERM (U1227), LabEx IGO, Brest, France.

Public Agency for Clinical Research and Innovation (DRCI), Brest University Hospital, Brest, France.

出版信息

Rheumatology (Oxford). 2025 Jun 1;64(6):3739-3746. doi: 10.1093/rheumatology/keae690.

DOI:10.1093/rheumatology/keae690

PMID:39700419

Abstract

OBJECTIVES

Salivary gland ultrasound (SGUS) has an interest in primary Sjögren's disease (pSD) for diagnosis, but the evolution of parenchymal lesions over time is unknown. The objective of this study was to assess the severity of ultrasound abnormalities in relation to pSD duration from the time of buccal dryness onset.

METHODS

In this cross-sectional international multicentre study, patients with pSD according to the 2002 or 2016 ACR/EULAR classification criteria were included. Parenchymal abnormalities were classified according to the semiquantitative score as defined by OMERACT. Patients were separated into four groups (Group A: <5 years, Group B: 5-9 years, Group C: 10-20 years and Group D: >20 years from the onset of buccal dryness). The association between disease duration groups and SGUS lesions was quantified in terms of odds ratios and 95% confidence intervals.

RESULTS

A total of 247 patients were consecutively included between May 2019 and February 2022. Eighty-nine percent of patients had a focus score ≥1/4 mm2, and 85% had positive anti-Ro/SSA. pSD duration was associated with a pathological OMERACT score (score 2 or 3): OR for 5-year duration: 1.23 [95% CI 1.04; 1.47], P = 0.038. Considering each US item, the only statistical association with pSD duration was found regarding the presence of hyperechoic bands (25% or more): OR for 5-year duration 1.18 [95% CI 1.03; 1.36], P = 0.038), independent of an older age.

CONCLUSION

pSD duration was associated with the presence of hyperechoic bands, but not with hypoechoic areas, suggesting a progressive fibro-adipose evolution.

摘要

目的

唾液腺超声（SGUS）对原发性干燥综合征（pSD）的诊断具有重要意义，但实质病变随时间的演变尚不清楚。本研究的目的是评估自口腔干燥症发作以来，超声异常的严重程度与pSD病程的关系。

方法

在这项横断面国际多中心研究中，纳入了符合2002年或2016年美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）分类标准的pSD患者。根据OMERACT定义的半定量评分对实质异常进行分类。患者被分为四组（A组：口腔干燥症发作<5年，B组：5-9年，C组：10-20年，D组：>20年）。疾病持续时间组与SGUS病变之间的关联通过比值比和95%置信区间进行量化。

结果

2019年5月至2022年2月期间，共连续纳入247例患者。89%的患者焦点评分≥1/4 mm2，85%的患者抗Ro/SSA阳性。pSD病程与病理OMERACT评分（2或3分）相关：病程5年时的比值比为1.23 [95%置信区间1.04；1.47]，P = 0.038。考虑到每个超声项目，与pSD病程唯一的统计学关联是关于高回声带的存在（25%或更多）：病程5年时的比值比为1.18 [95%置信区间1.03；1.36]，P = 0.038），与年龄较大无关。