摘要 ：目的：唾液腺超声检查(SGUS)已应用于诊断干燥综合征(SS)。本研究的目的是探讨SGUS表现与SS的临床、病理和血清学特征的相关性。

        方法：共有104例疑似SS的患者进行了SGUS检查以评价唾液腺受累的情况。根据SS分类标准确定原发性SS患者。双侧腮腺和颌下腺的实质不均匀改变分级为0(均匀)至4分(明显均匀)。应用受试者工作特征曲线(ROC)分析不同SGUS评分方法的诊断效能。比较依据SGUS评分分组的患者临床和血清学特征。多变量线性回归分析评价SGUS和SS这些特征的相关性。

        结果：研究对象主要为女性(96.2%)，平均年龄为54.1岁。分别有87例和88例患者基于AECG标准和ACR/EULAR SS的分类标准确定为原发性SS。不同的评分方法中，四个唾液腺评分的总和(范围0-16)具有最好的诊断效能，区分原发性SS和非SS性Sicca的敏感性为77.3%，特异性为87.5%(阈值，7)。SGUS评分与唇腺活检病灶评分(β= 0.240，P = 0.033)和抗Ro/SSA抗体阳性(β= 0.283，P = 0.016)正相关，与非刺激性唾液流率负相关(β= -0.298，P = 0.011)。

        结论：唾液腺超声表现与小涎腺组织病理学、SS血清学和唾液腺功能相关。

        附原文：Abstract OBJECTIVE:Salivarygland ultrasonography (SGUS) has been applied in the diagnosis ofSjögren'ssyndrome(SS). The aim of this study is to investigate theassociation of SGUS findings with clinical, histological, and serologicfeatures of SS.METHODS:A total of 104 patients with suspected SS underwent SGUSfor evaluation of salivary gland involvement. Patients with primary SS weredetermined according to the classification criteria for SS. The parenchymalinhomogeneity of bilateral parotid and submandibular glands was graded from 0(homogeneity) to 4 (gross inhomogeneity). Receiver operating characteristiccurve analysis was performed to compare the diagnostic performance of differentSGUS scoring methods. Clinical and serologic features were compared between groupsclassified by SGUS score. The association between SGUS and these features of SSwas explored by multivariable linear regression analysis.RESULTS:Studyparticipants were predominantly women (96.2%) and had a mean age of54.1years. Eighty-seven patients and 88 patients with primary SS wereidentified based on AECG criteria and ACR/EULAR classification criteria for SS,respectively. Among the different scoring methods, the sum of the grades offour salivary glands (range 0-16) had the best diagnostic performance, withsensitivity of 77.3% and specificity of 87.5% (cutoff value, 7) fordistinguishing primary SS from sicca non-SS. SGUS score was associated withfocus score in labial salivary gland biopsy (β=0.240,p=0.033) and anti-Ro/SSA serology (β=0.283,p=0.016) and inversely associated with unstimulated whole salivaryflow (β=-0.298, p=0.011).CONCLUSION:Ultrasonography ofmajor salivary glands is associated with histopathology of minor salivaryglands, serology of SS, and salivary gland function.

        引自：

        Kim JW,Lee H,Park SH,Kim SK,Choe JY,Kim JK.Salivary gland ultrasonography findings areassociated with clinical, histological, and serologic features ofSjögren'ssyndrome.Scand J Rheumatol.2018 Feb 7:1-8.doi: 10.1080/03009742.2017.1374451.[Epub ahead of print]