唾液腺超音波在乾燥症候群與乾燥症狀病人之應用──初步報告

Salivary gland ultrasonography and its applications in patients with Sjögren's syndrome and sicca symptoms: a preliminary report

目的：評估唾液腺超音波在乾燥症候群及有乾燥症狀病人，和其臨床檢驗數據以及病人症狀的關連性。方法：25位病人納入此研究。病人須符合原發性乾燥症候群或次發性乾燥症候群之診斷條件，或是具有乾燥症狀。這些病人的檢驗數據和就診記錄被納入分析。所有病人接受腮腺及頜下腺之唾液腺超音波檢查，每個腺體分別評以0-4分，總分最多16分。同時，這些病人亦接受ESSPRI量表評估其臨床症狀。結果：三組的平均ESSPRI量表值分別為原發性乾燥症候群11.91（95% CI: 8.08-15.74），次發性乾燥症候群11.00（95% CI: 5.33-16.67），以及有乾燥症狀的病人12.00（95% CI: 4.17-19.83）。唾液腺超音波積分和血液anti-La/SSB濃度（β-coefficient 0.022, p 0.026），ESSPRI量表指數（β-coefficient 0.337, p 0.02）和乾燥量表（β-coefficient 0.717, p 0.035）相關，但是和血液anti-Ro/SSA濃度、疼痛量表、疲倦量表則沒有相關性。結論：唾液腺超音波提供了一種簡便的方法，可以評估乾燥症候群以及口腔乾燥的病人唾液腺的狀況，並且和病人的臨床乾燥症狀以及血液anti-La/SSB濃度相關。未來唾液腺超音波可能成為另一個評估乾燥症候群病人的指標。

Objective: To assess the utility of salivary gland ultrasonography for Sjögren’s syndrome and patients with sicca symptoms, including the correlations between clinical parameters and patients’ symptoms. Methods: Patients that fulfilled the classification criteria proposed by American College of Rheumatology for primary Sjögren’s syndrome and secondary Sjögren’s syndrome, and patients with sicca symptoms were enrolled. A total of 25 patients were collected. Their clinical and serological data were obtained from medical records and laboratory databases. Salivary ultrasonography was performed for parotid glands and submandibular glands, and each gland was scored 0-4, with a total maximum score of 16. The EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) was arranged for evaluation of patient symptoms. Results: The median ESSPRI scores for primary Sjögren’s syndrome and secondary Sjögren’s syndrome, and for patients with sicca symptoms were 13.00 (IQR: 5.00-16.00), 11.00 (IQR: 7.00-15.00), and 10.50 (IQR: 5.50-19.75), respectively. The salivary gland ultrasonography score correlated with the serum anti-La/SSB (β-coefficient 0.022, p 0.026), total ESSPRI score (β-coefficient 0.337, p 0.02) and dryness score (β-coefficient 0.717, p 0.035), but not with the serum anti-Ro/SSA level, pain score, and fatigue score. Conclusion: Salivary ultrasonography provides a easy access for evaluation of the severity of salivary gland involvement in patients with Sjögren’s syndrome and sicca symptoms, and correlates with the patients’ clinical symptoms score and serum anti-La/SSB level; therefore, they may be parameters that can be used in evaluating patients with Sjögren’s syndrome.