Corticosteroid irrigation of parotid gland for treatment of xerostomia in patients with Sjogren's syndrome

为探讨激素腮腺冲洗对缓解干燥综合征患者唾液流动不足的疗效，对39例原发性干燥综合征患者(29例)和10例继发性干燥综合征患者(10例)分别用生理盐水和激素溶液冲洗腮腺。用撒克逊试验评估唾液功能。激素冲洗使干燥综合征患者的唾液流率显著增加(p&lt；0.0001)，首次皮质激素冲洗后临床症状改善4.0“*”2.6周。唾液功能改善的程度与病情严重程度成反比，早期患者唾液流率净增加1.20×0.57g，晚期患者净增加0.20×0.47g。反复类固醇冲洗没有引起唾液腺的类固醇不耐受；在这些患者中，在第二次到第四次皮质类固醇激发后，观察到类似水平的唾液流率净增加。持续时间为8.6个月，提示糖皮质激素冲洗疗法在缓解干燥综合征患者口干症方面有临床应用价值。

The purpose of this study was to determine the efficacy of corticosteroid irrigation of the parotid gland in relieving salivary flow deficiency in patients with Sjogren's syndrome.The parotid glands of thirty-nine patients with primary (twenty nine) or secondary (ten) Sjogren's syndrome were irrigated either with saline solution followed by corticosteroid solution. Salivary function was assessed by Saxon test.Corticosteroid irrigation significantly increased the salivary flow rate in patients with Sjogren's syndrome (p< 0.0001), with clinical improvement detectable 4.0 "*" 2.6 weeks after initial corticosteroid irrigation. The extent of improvement in salivary function was reciprocal to the clinical severity of the disease, with patients at the early stages obtaining 1.20*0.57 g net increase in salivary flow rate, and patients at the most advanced stages obtaining 0.20 "*" 0.47 g net increase. Repeated steroid irrigations did not evoke steroid refractoriness of the salivary gland ; similar levels of net increase in salivary flow rate were observed after the second to fourth challenge of the corticosteroid in these patients. The sustained period was 8.6 months.These findings suggest the clinical usefulness of corticosteroid irrigation therapy in relieving xerostomia in patients with Sjogren's syndrome.