| 摘要: |
| 目的探讨涎腺超声联合血清B淋巴细胞刺激因子（BAFF）检测在原发性干燥综合征（pSS）诊断中的临床价值。方法选择pSS患者80例（pSS组），类风湿关节炎（RA）患者60例（RA组），健康体检者20例（健康对照组）。采用ELISA法检测各组血清BAFF、增殖诱导配体（APRIL）、TNF-ɑ、IL-1β及IL-6水平；通过二维超声评估pSS患者涎腺受累情况。分析比较各组血清BAFF、APRIL、TNF-ɑ、IL-1β、IL-6水平，并分析pSS患者血清BAFF、APRIL、TNF-ɑ、IL-1β、IL-6与涎腺超声评分的相关性。结果3组血清BAFF、IL-1β、TNF-ɑ比较差异均有统计学意义（均P＜0.05），其中pSS组患者血清BAFF、IL-1β、TNF-ɑ水平明显高于RA组与健康对照组，差异均有统计学意义（均P＜0.05）。pSS患者血清BAFF与涎腺评分呈负相关（r=-0.462，P＜0.05），血清IL-1β与涎腺评分呈正相关（r=0.403，P＜0.05）。涎腺超声、血清BAFF对pSS诊断的灵敏度高于抗干燥综合征A抗原（SSA）/干燥综合征B抗原（SSB）、类风湿因子（RF），差异均有统计学意义（均P＜0.05）。对于涎腺超声评分≤2分的早期pSS患者，涎腺超声联合BAFF检测诊断特异度达到96.77%。结论pSS患者血清BAFF在疾病的早期即有明显升高，有助于早期诊断。涎腺超声对pSS的诊断比抗SSA/SSB有更高的灵敏度，特异度相当；BAFF对pSS的诊断比抗SSA/SSB灵敏度高，但特异度较低。对于涎腺超声评分≤2分的pSS患者，涎腺超声联合血清BAFF检测可提高诊断的特异度，可作为早期筛查指标。 |
| 关键词: B 淋巴细胞刺激因子 涎腺超声 原发性干燥综合征 |
| DOI：10.12056/j.issn.1006-2785.2017.39.21.2017-1608 |
| 分类号: |
| 基金项目:2017年宁波市自然基金（2017A610208） |
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| Serum BAFF test combined with salivary gland ultrasonography in diagnosis of primary Sjogren's syndrome |
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Ningbo Second Municipal hospital
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| Abstract: |
| Objective To assess the value of serum BAFF level combined with salivary gland ultrasonography in diagnosis of primary Sjogren's syndrome (pSS). Methods The serum levels of BAFF, APRIL, TNF-ɑ, IL-1β and IL-6 were measured by ELISA in 80 pSS patients, 60 rheumatoid arthritis(RA) patients and 60 healthy controls. Salivary gland was examined with two-dimensional ultrasonography in three groups. The correlation of serum levels of BAFF, APRIL, TNF-ɑ, IL-1β, IL-6 and salivary gland ultrasonography with pSS was evaluated. Results The serum levels of BAFF, IL-1β, TNF-ɑ in pSS patients were significantly higher than those in RA patients and healthy controls (all P＜0.05), while there were no significant differences in serum levels of APRIL and IL-6 among tree groups. The salivary gland ultrasound scores was negatively correlated with serum BAFF level (r=-0.462, P ＜0.05) and positively correlated with IL-1β level (r=0.403, P ＜0.05). The sensitivity of salivary ultrasonography in diagnosis of pSS was higher than that of SSA/SSB and the specificity was similar. The sensitivity of serum BAFF in diagnosis of pSS was higher than that of SSA/SSB, but the specificity was lower. For pSS patients with ultrasonic score ＜ 2min, the specificity of ultrasonography combined with BAFF was increased to 96.77%. Conclusion Serum BAFF measurement
combined with salivary gland ultrasound examination can be used for screening and diagnosis of primary Sjogren's syndrome. |
| Key words: B cell activating factor Salivary gland ultrasonography Primary Sjogren's syndrome |
