原发干燥综合征并发神经系统损害的临床研究

Clinical study on neurological injuries complicated by primary Sjogren's Syndrome

目的通过对患有原发干燥综合征(pSS)患者临床表现和血液生化及免疫学指标的检测,探讨pSS的神经系统损害。方法选择在我院门诊和住院确诊的218例pSS患者,对有神经系统临床表现的65例患者的临床症状、体征以及实验室分析结果进行回顾性研究。结果 pSS患者中29.8%出现了神经系统损害的临床表现,其中头痛、耳鸣占53.8%;面部感觉减退、麻木占7.7%;脱髓鞘改变为10.7%;末梢感觉减退、麻木感为29.2%;偏瘫症状为9.2%;锥体束征阳性体征及单纯性癫痫症状占13.8%。对所有pSS患者血液学检查抗SS-A抗体及抗SS-B抗体均呈阳性反应。这些病例中92.3%血沉增快,IgG和IgA升高,分别为80%和46.1%。影像学检查中证明44.6%的患者显示有中枢神经系统损害。结论 pSS患者的临床表现尽管出现了多样性变化,但从其症状与体征、血液生化及免疫学指标的检测中,发现损伤多以周围神经及中枢神经系统的病变为主,这与发病和病情的活动程度密切相关(r=0.98)。

【Objedtive】 To investigate the neurological injuries of primary Sjogren’s Syndrome（pSS） by clinical observation on pSS patients and the testing on biochemical and immunological indices in blood.【Methods】 Select 65 patients with neurological clinical manifestation among 218 confirmed pSS patients at clinic and hospital for retrospective study.【Results】 29.8% pSS patients showed neurological injuries started from many systems,by hematological examination,SS-A antibodies and SS-B antibodies of all pSS patients were positive,92.3% of erythrocyte sedimentation was fast,IgG and IgA were high.By imageology examination,44.6% patients showed central nervous system injury.【Conclusion】 These pSS patients injuries were mostly the lesion at peripheral and central nervous system,in spite of the various clinical manifestations,which were closely associated with morbidity and the state of illnesses.