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Relationship between Peripheral Neuropathy and Anti-Ro/La in Patients with Primary Sjögren Syndrome

目的　探讨原发性干燥综合征周围神经病变的发生与干燥综合征A型/B型抗体（抗SSA/SSB抗体）的关系。 方法　纳入2009年1月－2011年12月期间门诊及住院收治的原发性干燥综合征患者88例。所有患者均接受神经系统检查，采用蛋白质印迹法检测抗SSA抗体和抗SSB抗体，利用全自动化学发光仪检测血清维生素B12水平。 结果　88例原发性干燥综合征患者中有27例（30.7%）存在周围神经病变。有或无周围神经病变的患者在年龄、性别、病程等一般情况方面无明显不同。有周围神经病变和无周围神经病变的原发性干燥综合征患者抗SSA抗体阳性率分别为70.4%（19/27）、70.5%（43/61），差异无统计学意义（χ2=0.000，P=0.991）；抗SSA/SSB抗体双阳性率分别为63.0%（17/27）、14.8%（9/61），差异有统计学意义（χ2=17.416，P=0.000）；血清维生素B12水平分别为（390 ± 55）、（410 ± 86）pg/dL，差异无统计学意义（t=0.908，P=0.370）。 结论　周围神经病变在原发性干燥综合征患者中较常见，且周围神经病变的发生多伴随血清抗SSA/SSB抗体阳性。

干燥综合征误诊为腮腺肿瘤一例

Clinical Review of 17 Primary Biliary Cirrhosis

目的：分析原发性胆汁性肝硬化(PBC)患者的临床特征,以提高对该病诊治的认识。方法：分析17例PBC患者的一般资料、临床表现、生化指标、免疫学指标及病理学改变。结果：PBC主要累及中年女性，易合并干燥综合征（SS）。胆管酶升高及抗线粒体M2抗体阳性有助于本病诊断。治疗首选熊去氧胆酸，糖皮质激素、免疫抑制剂适用于合并SS者。结论：早期诊断、早期治疗PBC是防止发展为终末期肝硬化的关键。

Quality Assessment of Randomized Controlled Trials on Treatment of Sjogren’s Syndrome with Traditional Chinese Medicine

Objective　To investigate the current situation of randomized controlled trials (RCTs) on the treatment of Sjogren’s syndrome with Traditional Chinese Medicine (TCM), and to assess whether there is adequate evidence for clinical practice. Methods　Such databases as CNKI, VIP, CBM and PubMed were searched from their establishment date to June 2010 to collect the RCTs on the treatment of Sjogren’s syndrome with TCM according to the predefined inclusion criteria. And the quality was assessed by using the Jadad scale, the revised CONSORT statement and other self-defined indexes.Results　Among 19 included RCTs, 1 literature scored four points, 4 scored two points, 13 scored one point, and 1 scored zero point according to Jadad scale; no RCT performed the allocation concealment. According to the CONSORT criteria, 19 RCTs accounting for 100% reported the diagnostic criteria, implement of interventions and result, 11 RCTs applied the 2002 international diagnosis and classification criteria of Sjogren’s syndrome, 17 RCTs carried out positive control including one based on the standard treatment, and two RCTs applied only blank control without placebo control. All RCTs took the comprehensive efficacy assessment as the outcome index, but only 6 RCTs (31.6%) assessed both clinical efficacy and TCM syndrome efficacy. Among 6 RCTs (31.6%) describing the random sequence, no RCT reported the detailed methods. Except 1 RCT (5.3%) carried out the double blinding, all the others were non-blind trials. And only 1 RCT adopted analog. Conclusion　Currently, the methodology and reporting quality of studies on the treatment of Sjogren’s syndrome with TCM are not good enough to provide reliable evidence for clinical practice.

The Clinical Efficacy of Total Glucosides of Peony in the Treatment of Primary Sjögren’s Syndrome

目的　观察白芍总苷治疗原发性干燥综合征的疗效及不良反应。 方法　收集2008年1月－2012年1月诊断的原发性干燥综合征患者48例，使其口服白芍总苷0.3～0.6 g，3次/d，疗程6个月，对比治疗前后患者的临床症状及唾液腺功能（唾液腺核素显像定量分析）改善情况、泪液分泌试验（Schirmer试验）、血沉、C反应蛋白、血清γ球蛋白（采用琼脂糖凝胶电泳法）的改善情况，并记录可能的不良反应。 结果　经过6个月的治疗，患者的临床症状、血沉、C反应蛋白、血清γ球蛋白等方面情况有所改善，差异有统计学意义（P＜0.05）。但唾液腺功能、Schirmer试验改善不明显，差异无统计学意义（P＞0.05）。 结论　白芍总苷在改善原发性干燥综合征临床症状及实验室指标疗效好，不良反应少，但在改善唾液腺功能及泪腺功能疗效欠佳。

Comparative Ultrasonography with Radionuclide Imaging Evaluating Parotid of Sjogren Syndrome

摘要:目的:探讨超声与核素显像在评价干燥综合征(SS)腮腺受累情况中的价值和作用。方法:对65例SS病人分别进行超声和核素显像检查。结果:超声判为腮腺功能0级、I级、ⅡⅢ级、Ⅳ级的能力与核素显像判为正常(χ2=0.075,Pgt;0.05)、轻度(χ2=0.12,Pgt;0.05)、中度(χ2=0.27,Pgt;0.05)、重度(χ2=0.097,Pgt;0.05)受损的能力一致,差异无统计学意义;核素发现单纯摄取功能受损的超声多表现为不均匀型、单纯排泌功能受损的超声多表现为结节型、摄取和排泌功能均受损的超声多表现为纤维化型。结论:超声检查可作为SS患者腮腺受累情况评价的良好手段。Abstract: Objective: To quantitatively evaluate ultrasonography and radionuclide imaging in thediagnosis of parotid gland involvement in Sjogren syndrome (SS). Methods: Ultrasonography and radionuclide imaging were conducted on 65 cases with primary Sjogren syndrome. Results: There was no significant difference statistically between the ultrasonographic appearance of the parotid gland and radionuclide imaging (P gt;0. 05). Conclusion: As for diagnosis and evaluating the parotid gland of Sjogren syndrome, ultrasonography may be the useful choice.

干燥综合征并发脊髓炎一例

Analysis on the Correlation of Thrombopoietin and Anti-thrombopoietin Antibody with Thrombocytopenia in Patients with Primary Sjören Syndrome

ObjectiveTo analyze the correlation of thrombopoietin (TPO) and anti-TPO antibody with thrombocytopenia in patients with primary Sjögren syndrome (PSS). MethodsWe included in our study 40 PSS patients with thrombocytopenia (group A), 22 PSS patients who once had thrombocytopenia and returned to normal (group B), 40 PSS patients with normal platelet counts (group C) and 40 healthy controls (group D) between September 2013 and October 2014. Anti-TPO antibody was detected by indirect enzyme-linked immunosorbent assay (ELISA), and serum TPO levels were measured by ELISA. We analyzed the relationship between the assay results and the clinical manifestations and parameters. ResultsThe serum TPO levels in groups A, B, and C were (129.74±17.47) , (330.23±18.07) and (364.19±12.25) pg/mL, respectively, and they were significantly higher than that in group D [(54.04±10.71) pg/mL] (P ＜ 0.05) . The serum level of TPO was positively correlated with CRP and IgA (rs=0.224, P=0.039; rs=0.239, P=0.033) , and was negatively correlated with C4 level (rs=?0.220, P=0.041) , but it was not significantly correlated with platelet count, erythrocyte sedimentation rate, the level of antiphospholipid antibodies and the titer of antinuclear antibodies (P ＞ 0.05) . The positive rate of PSS patients was 20.59% (21/102) and the rate in groups A, B, and C was respectively 17.5% (7/40) , 22.72% (5/22) , and 22.5% (9/40) . There was no statistically significant difference between the positive and negative groups in various clinical indexes (P ＞ 0.05) . ConclusionAntiTPO antibody may not be the main mechanism of thrombocytopenia in PSS patients, and there is a certain correlation between TPO and inflammatory factors.

干燥综合征合并视神经炎七例

视神经脊髓炎谱系疾病合并重症肌无力、干燥综合征及桥本甲状腺炎首例报告