干燥综合征的腮腺和颌下腺损害特点分析

The characteristics of parotid and submandibular impairment in Sjogren’s syndrome

目的:通过比较干燥综合征组和正常对照组进行放射性核素显像的定量参数差异,观察干燥综合征患者的腮腺和颌下腺损害的特点。方法:38例干燥综合征患者均符合2002年干燥综合征国际分类(诊断)标准,对照组14例,所有病例按常规行唾液腺动态显像,并计算获得3项摄取功能参数:4min摄取比值(UR4)、15min摄取比值(UR15)、摄取速率(UV);3项排泄功能参数:最大排泄量(MS)、酸刺激后腺体计数下降到最低所需的时间(Tmin)和1min内排泄速率(SV1min),将两组定量参数进行t检验和Mann-WhitneyU检验。结果:干燥综合征组腮腺不显影或显影不清楚的有2例(2/38),干燥综合征组腮腺功能参数SV1min、UR15明显减低;颌下腺不显影或显影不清楚的有14例(14/38),干燥综合征组颌下腺功能参数(包括UR4、UR15、UV、MS、SV1min)均较对照组明显减低。结论:干燥综合征患者的腮腺与颌下腺功能损害并不是完全一致的。颌下腺损害更加常见,摄取和排泌量及速度均减低;腮腺仅高峰摄取比值和早期排泌速率明显减低,摄取速率和排泄量可表现正常。

Objective： To explore the differences of quantitative parameters of salivary glands scintigraphy in patients with Sjogren’s syndrome and normal control group. Methods： Salivary gland scintigraphy was performed in 38 patients clinically diagnosed as Sjogren’s syndrome and 14 healthy subjects. Three uptake parameters and three washout parameters were calculated as follows： uptake ratio at 4 minute（UR4）, uptake ratio at 15 minute（UR15）, uptake velocity（UV）, maximum secretion（MS）, time interval from stimulation to minimum count （Tmin）, and secretion velocity in the first minute （SV1min）. All parameters were expressed as x±s. An unpaired t test and the Mann-Whitney U test were used to statistically analyze all mean values and to compare differences between the two groups. Results： Two of the 38 patients were observed as unclear image of parotid. Of all parotid parameters, UR15 and SV for both parotid glands in patient group were significantly lower than those of the control group; 14 of the 38 patients were obsevred as unclear image of submandibular. UR4, UR15, UV, MS, SV1min for both submandibular glands in case group were significantly lower than those of the control group. Conclusions： Submandibular function impairment was more common and severe than parotid in Sjogren’s syndrome patients. All uptake and washout parameters except Tmin decreased with submandibular glands. But only maximum uptake and secretion velocity decreased with parotid glands.