干燥综合征酸刺激试验前后腮腺血流动力学变化的研究

The study of hemodynamic changes of parotid glands in patients with Sjogren syndrome before and after acid stimulation test

目的探讨干燥综合征患者酸刺激试验前后腮腺血流动力学的特征。方法选择干燥综合征女性患者20例（病例组），另选择同期非干燥综合征女性健康志愿者20例（对照组），应用彩色多普勒超声检测两组酸刺激试验前后双侧颞浅动脉和腮腺内小动脉的血流频谱，获得收缩期最大血流速度（PsV）、舒张末期最低血流速度（EDV）和阻力指数（RI），并进行比较分析。结果酸刺激试验前，病例组腮腺内小动脉PSV、EDV高于对照组[（16．01±6．18）cm/s比（14．00±5．23）cm／s，（5．96-1-3．00）cm／s比（3．54±2．03）cm／s，RI低于对照组（0．64±0．07比0．76±0．06）]，差异有统计学意义（P〈0．05），病例组颞浅动脉血流动力学参数与对照组比较差异无统计学意义（P〉0．05）。酸刺激试验后，对照组颞浅动脉和腮腺内小动脉的PSV及EDV均较酸刺激试验前增高，RI减低，差异有统计学意义（P〈0．05）；而病例组颞浅动脉和腮腺内小动脉的血流动力学参数与酸刺激试验前比较差异均无统计学意义（P〉0．05）。结论干燥综合征患者腮腺供血动脉对酸刺激试验的反应性减低，尤以腮腺内小动脉较为敏感，彩色多普勒超声可以有效反映腮腺病变的血流动力学变化，有助于对腮腺功能受损程度进行评价。

Objective To explore the hemodynamic characteristics of parotid glands before and after acid stimulation test in patients with Sjogren syndrome. Methods Twenty female patients with Sjogren syndrome were enrolled as case group, and 20 healthy women were selected in the same period as control group. The blood flow spectrums of bilateral superficial temporal artery and intra-parotid small artery before and after acid stimulation were detected by color Doppler uhrasonography. Peak systolic velocity （PSV）, end-diastolic minimum velocity（EDV） and resistance index（RI） were obtained and analyzed. Results PSV and EDV of intra-parotid small artery in case group were significantly higher than those in control group before acid stimulation test, and RI was obviously lower than that in control group [ （16.01 ± 6.18） cm/s vs. （ 14.00 ± 5.23 ） cm/s, （5.96 ± 3.00） cm/s vs. （ 3.54 ± 2.03 ） cm/s, 0.64 ± 0.07 vs. 0.76 ± 0.06 ] （P 〈 0.05 ）. In control group, PSV and EDV of superficial temporal artery and intra-parotid small artery increased and RI reduced after acid stimulation test,which had significant differences before and after acid stimulation test （P 〈 0.05 ）. There was no statistical significance in the hemodynamic indexes of case group before and after acid stimulation test（P〉 0.05）. Conclusions The reactivity ofparotid artery to acid stimulation test in patients with Sjogren syndrome reduce, especially the intra-parotid small artery. Color Doppler ultrasonography can contribute to show the hemodynamic changes of the parotid lesions efficiently.