摘要目的 探讨干燥综合征(SS)患者下唇唇腺病理与临床特点的相关性.方法 对我院119例可疑SS患者的唇腺组织病理学改变、眼科检查结果、抗核抗体谱及临床特点进行分析,确诊SS 84例.根据唇腺病理结果,浸润灶指数(FS)(+)患者为64例,FS(-)患者为20例.FS(+)组中异位生发中心结构(GC)(+)患者20例,GC(-)患者44例.计量资料采用了独立样本t检验或秩和检验,计数资料采用X2检验.结果 FS(+)组较FS(-)组的病程及口干或眼干症状持续时间长[(70±96)、(40±29)个月与(20±28)、(10±16)个月,P＜0.05 ].FS(+)组中GC(+)较GC(-)患者的口干、眼干持续时间更长[(72±23)与(25±17)个月,P＜0.01],血清中IgG水平、唇腺组织中的平均FS积分及系统累及率增高(P＜0.05).FS(-)组中6例(占30%)患者唇腺组织有退行性变,其口干、眼干持续时间以及系统累及率高于唇腺组织正常者.结论 FS(+)组患者中GC(+)及FS(-)患者唇腺组织的退行性变均提示患者症状重、疾病活动度及系统累及率高,提示这些改变与病情重、预后差相关,临床上应该更加关注这部分患者.

abstractsObjective To evaluate the correlation between pathological findings and clinical characteristics of patients with Sj(o)gren's syndrome (SS). Methods Eighty-four patients diagnosed with SS from 119 suspected ones at Peking University First Hospital were recruited. According to the pathological changes of lip biopsy, 64 patients were focus score (FS)( + ) and 20 patients were FS (-). In the FS( + ) group, 20 patients had germinal center (GC)( + ) and 44 patients had no GC. x2 test and t test were used for statistical analysis. Results The duration of symptoms of dry eyes or dry mouth in the FS (+) group was longer than that in the FS (-) group (P＜0.05). In the FS ( + ) patients, those with GC (+) had significantly longer duration of xerothalmia or xerostomia, higher serum IgG levels, greater FS score, and higher incidence of system involvement than those without GC patients (P＜0.05). In the FS (-) group, lip biopsies showed degenerative changes in 6 (30%) patients. Those with degenerative changes had longer duration of dry eyes and dry mouth and higher incidence of system involvement. Conclusion GC (+) in FS (+) patients and degenerative changes in FS (-) patients from lip biopsy are associated with severer clinical manifestations in patients with SS, suggesting that more clinical attention should be paid to this subgroup of patients.