原发性干燥综合征国际分类标准中口腔诊断项目的临床评价

目的:评价2002年国际分类(诊断)标准各分项条目在原发性干燥综合征(primary Sjgren’s syndrome,pSS)诊断中的临床意义。方法:收集pSS患者的完整资料进行回顾性分析,患者临床表现和实验室检查结果均符合2002年pSS国际分类诊断标准。结果:共收集到148例pSS患者的临床资料,在口腔科各项诊断条目中,98.0%的患者有口干症状,96.6%的患者唾液静态流率减少,60.1%的pSS患者的腮腺造影符合干燥综合征的特征性改变。血清学检查项目中,79.7%的患者出现抗SSA抗体阳性,75.0%的患者免疫球蛋白升高。有20.3%(30/148)的患者最终需通过唇腺活检获得确证诊断。结论:2002 pSS国际分类诊断标准口腔各分项诊断条目中,口腔症状和唾液静态流率测定敏感度较好,是干燥综合征诊断中的重要依据。

Clinical assessment of oral diagnostic items in 2002 classification criteria for primary Sjogren's syndrome

Objective: To evaluate the diagnostic value of each item in 2002 international classification criteria for primary Sjgren’s syndrome(pSS) in clinically diagnosed cases.Methods: All patients were from the Department of Oral Medicine of Peking University School of Stomatology from 2005 to 2010.Their clinical manifestations and lab testing results met the standard criteria and the diagnosis was established according to international classification criteria(2002).We retrospectively collected all of the clinical and information and did the data analysis.Results: A total of 148 pSS patients were included in the study.When the oral evaluations were performed,98.0% of the patients complained dry mouth,96.6% of them had decreased non-stimulated salivary flow rate,and 60.1% had positive parotid sialography results,which was consistent with diagnosis.It was found out in the lab testing that 79.7% of the patients had positive anti-SSA antibody,and 75.0% of them had elevated globulin level.20.3% of the patients were finally diagnosed by performing the lower lip biopsy.Conclusion: When applying 2002 international classification criteria for the diagnosis of pSS patients,oral symptoms and unstimulated salivary flow rate are feasible and sensitive,which play an important and indicative role in the diagnosis of pSS.