摘要
目的分析原发性干燥综合征(PSS)瘀毒证与涎腺超声表现及血清干扰素调节因子4(IRF4)、B细胞活化因子(BAFF)、C-X-C序列趋化因子配体13(CXCL13)水平的相关性。方法以符合纳入标准的48例PSS瘀毒证患者、36例PSS非瘀毒证患者及24例健康对照人群为研究对象。所有研究对象均接受涎腺超声检查,依据评分标准进行超声下涎腺病变总评分并记录病变类型,同时检测血清IRF4、BAFF、CXCL13、抗核抗体、抗SSA抗体、抗SSB抗体、免疫球蛋白(IgM、IgG、IgA)及血清补体C3、C4水平。此外,对所有PSS患者进行疾病活动度(ESSDAI)评估并记录分数,并对所收集的相关数据进行统计分析。结果84例PSS患者中瘀毒证组48例,非瘀毒证组36例,非瘀毒证组中气阴两虚证11例、阴虚血瘀证10例、肝肾阴虚证9例、阴虚燥热证6例。与健康对照组相比,PSS患者涎腺均存在不同程度的病变,其中PSS-瘀毒证组患者超声下涎腺病变总评分、腺体低回声结节比例均高于PSS-非瘀毒组患者(P<0.05),同时PSS-瘀毒证组患者ESSDAI评分高于PSS-非瘀毒组患者(P<0.05)。与健康对照组相比,PSS患者血清BAFF、CXCL13、IgG水平及ANA、抗SSA、抗SSB阳性率均较高(P<0.05),其中PSS-瘀毒证组患者血清BAFF、CXCL13、IgG水平高于PSS-非瘀毒组患者(P<0.05)。PSS患者与健康对照组在血清IRF4、IgA、IgM、补体C3、补体C4水平方面比较差异无统计学意义(P>0.05)。结论与非瘀毒证患者相比,PSS-瘀毒证患者整体病情更重,腺体损伤更为明显。瘀毒证是PSS病情发展中的关键阶段,尽早、准确识别瘀毒证尤为重要,而PSS患者涎腺超声下低回声结节、血清IgG、BAFF、CXCL13高表达可作为辨别瘀毒证的客观参考依据。
Objective To analyze the correlation between primary Sjogren′s syndrome(PSS)with blood stasis syndrome and salivary gland ultrasound and serum IRF4,BAFF,CXCL13 levels.Methods 48 PSS patients with blood stasis syndrome,36 PSS patients with non-stasis toxin syndrome and 24 healthy controls who met the inclusion criteria were selected as the research objects.All subjects underwent salivary gland ultrasound examination.According to the scoring standard,the total score of salivary gland lesions under ultrasound and the type of lesion were recorded.At the same time,serum interferon regulatory factor 4(IRF4),B cell activation factor(BAFF),CXC sequence chemotaxis were detected Factor ligand 13(CXCL13),anti-nuclear antibody,anti-SSA antibody,anti-SSB antibody,immunoglobulin(IgM,IgG,IgA)and serum complement C3 and C4 levels.In addition,the disease activity(ESSDAI)of all patients with PSS was evaluated and scores were recorded,and statistical analysis was performed on the collected data.Results 84 patients with PSS had 48 cases in the blood stasis toxin syndrome group,36 cases in the non-stasis toxin syndrome group,11 cases in the non-stasis toxin syndrome group,11 cases in qi and yin deficiency syndrome,10 cases in yin deficiency and blood stasis syndrome,9 cases in liver and kidney yin deficiency syndrome Cases,6 cases of Yin deficiency and dry heat syndrome.Compared with the healthy control group,the salivary glands of PSS patients have different degrees of disease.Among them,the total score of salivary gland lesions under ultrasound and the proportion of hypoechoic glandular nodules in the PSS-blood stasis group are higher than those in the PSS-non-stasis group Patients(P<0.05),and the ESSDAI score of the PSS-Stagnation syndrome group was also higher than that of the PSS-Non-stasis syndrome group(P<0.05).Compared with the healthy control group,the serum BAFF,CXCL13,IgG levels and the positive rates of ANA,anti-SSA,and anti-SSB in PSS patients were higher(P<0.05).Among them,the serum BAFF,CXCL13,and IgG levels in the P
作者
陈自佳
韦尼
CHEN Zi-jia;WEI Ni(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078)
出处
《世界中西医结合杂志》
2020年第8期1536-1539,1543,共5页
World Journal of Integrated Traditional and Western Medicine
基金
北京中医药大学自主课题青年教师项目(2017-JYB-JS-105)
北京中医药大学东方医院1166人才培养计划。
