Gu Y Y, Jiang Y H, Bao C D
Ren Ji Hospital, Shanghai Second Medical University.
Zhonghua Nei Ke Za Zhi. 1994 Sep;33(9):597-600.
Labial salivary gland biopsy (LSG-B) along with Schirmer test and kerato-conjunctival staining with fluorescein dye was performed in 196 patients with suspected Sjogren's syndrome (SS). Of the 196 patients, 117 were found to have 2 or more lymphocytic focus scores (LFS/4mm2) on their LSG-B specimens. 92 of them having keratoconjunctivitis sicca (KCS) as well met the diagnostic criteria of SS. Among the cases (25) without KCS, 16 with another CTD were diagnosed as secondary SS. 9 cases were classified as probable primary SS in this study because they had clinical manifestations of SS. Of the 11 cases with KCS only, 6 with another CTD were diagnosed as secondary SS; 5 befitted primary SS for abnormal findings on sialography. We also found that lymphocytic infiltration in LSG-B was much more severe in primary SS than in secondary SS; this could be attributed to the use of immunotherapy for the accompanying CTD in secondary SS. There was good association in our study between the severity of lymphocytic infiltration and systemic involvement.
对196例疑似干燥综合征(SS)的患者进行了唇腺活检(LSG - B),同时进行了Schirmer试验和荧光素染料角膜结膜染色。在这196例患者中,117例在其LSG - B标本上发现有2个或更多的淋巴细胞灶评分(LFS/4mm²)。其中92例同时患有干燥性角结膜炎(KCS),符合SS的诊断标准。在无KCS的病例(25例)中,16例合并其他结缔组织病(CTD)被诊断为继发性SS。本研究中有9例因具有SS的临床表现而被分类为可能的原发性SS。仅患有KCS的11例患者中,6例合并其他CTD被诊断为继发性SS;5例因唾液造影异常符合原发性SS。我们还发现,原发性SS患者LSG - B中的淋巴细胞浸润比继发性SS严重得多;这可能归因于继发性SS中对伴随的CTD使用了免疫疗法。在我们的研究中,淋巴细胞浸润的严重程度与全身受累之间存在良好的相关性。