Exocrine function in primary Sjogren syndrome: natural course and prognostic factors
Exocrine function in primary Sjogren syndrome: natural course and prognostic factors
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DOI：
10.1136/ard.2007.074203
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发表时间：
2008-07-01
影响因子：
27.4
通讯作者：
Brun, J. G.
中科院分区：
文献类型：
--
作者：
Haldorsen, K.;Moen, K.;Brun, J. G.
目的：很少有研究涉及原发性干燥综合征(SS)患者唾液和泪液功能的自然病程或预后因素。除早期外，腺体功能似乎稳定，SS A抗原(SSA)血清阳性和低补体血症可能预示着van Bijsterveld评分的下降。本研究的目的是根据美国和欧洲关于SS的共识标准，在一个更大的队列中评估外分泌功能的自然过程，并解决外分泌功能下降的可能预测因素。共141例患者接受了Schirmer I试验和非刺激性全唾液(UWS)检查。有关这些测试和焦点评分的历史数据是从111名患者的档案中收集的。从确诊到随访的中位时间为5.0年。结果：中位UWS在随访期间没有变化。Schirmer I试验中位数从5.0 mm/5min提高到7.0 mm/5min(p<；0.05)。目前的Schirmer I试验与既往高的Ig G和Ig A、阳性的SSA和SS B抗原(SSB)试验和高的病灶评分有关，并表现为既往C3/C4低的UWS。Logistic回归分析发现，高病灶分数(优势比(OR)=1.343)和低UW(OR=0.692)是预测Schirmer I试验恶化30%或更多的因素。高焦点分数(OR=1.488)预示着UWS恶化30%或更多。结论：我们证实了先前的研究表明，随着时间的推移，外分泌功能稳定或略有改善。高焦点评分和低UW被认为是外分泌功能恶化的独立预测因素。
Objectives: Few studies have addressed the natural course of, or prognostic factors for the salivary and lacrimal function in primary Sjogren syndrome (SS). Except for the early stages, glandular function has been seemingly stable, and SS A antigen (SSA) seropositivity and hypocomplementemia may predict a decline in the van Bijsterveld score. The aim of the present study was to assess the natural course of the exocrine function in a larger cohort based on the American-European consensus criteria for SS, and to address possible predictive factors for a declining exocrine function.Methods: We performed a retrospective cohort study. A total of 141 patients were investigated with the Schirmer I test and unstimulated whole saliva (UWS). Historical data regarding these tests and focus score were collected from the files of 111 patients. Median time from diagnosis to follow-up investigation was 5.0 years.Results: Median UWS was unchanged during follow-up. Median Schirmer I test improved from 5.0 to 7.0 mm/5 min (p< 0.05). Present Schirmer I test was associated with historical high IgG and IgA, positive SSA and SS B antigen (SSB) tests and high focus score, and present UWS with historical low C3/C4. Logistic regression identified high focus scores (odds ratio (OR)= 1.343), and low UWS (OR= 0.692) as factors predicting a 30% or more worsening of the Schirmer I test. High focus scores (OR= 1.488) predicted a 30% or more worsening of the UWS. Conclusion: We confirmed previous studies showing a stable or slightly improved exocrine function over time. High focus scores and low UWS were identified as independent predictors of a worsened exocrine function.