类风湿关节炎合并干燥综合征患者的临床及实验室特点

Clinical investigation of rheumatoid arthritis in patients with Sjogren Syndrome

目的探讨类风湿关节炎(RA)合并干燥综合征(SS)患者的临床及实验室特征,并与原发性干燥综合征(pSS)及单纯RA患者进行比较,了解RA合并SS患者的临床及血清学特点。方法随机入选单纯RA患者124例,同时参照SS诊断标准选取47例RA-SS患者及68例pSS患者进行比较。结果在47例RA-SS患者中24例(51.1%)患者的SS发生于RA之后,4例(8.5%)患者的SS发生于RA之前,19例(40.4%)患者为两病同时出现。与单纯RA组患者比较,RA-SS组患者RA发病年龄小,晨僵发生率低,乏力、口干眼干发生率高,抗核抗体(ANA)、抗干燥综合征A(SSA)抗体、抗干燥综合征B(SSB)抗体、IgG升高、C4降低及球蛋白升高的阳性率高,而C反应蛋白(CRP)升高的阳性率低,肺部病变及白细胞减少发生率高。与pSS组患者比较,RA-SS组患者病程长,受累关节数多,晨僵及畸形发生率高,乏力、眼干及口干的发生率低,ANA、抗SSA、抗SSB抗体阳性率低,而RF、抗CCP抗体、CRP及血沉(ESR)升高的阳性率高,肺部病变及贫血发生率高,白细胞减少发生率低。结论 RA-SS在临床并不少见,具有与单纯的RA及pSS不同的临床及实验室特征。

Objective To investigate the clinical and serologic features of rheumatoid arthritis （RA）in patients with Sjogren syndrome （SS）in comparison with primary Sjogren syndrome （pSS）and rheumatoid arthritis （RA）. Methods Forty-seven RA patients with SS （RA-SS）,124 RA patients without SS and 68 pSS were enrolled in this study,and clinical and laboratory parameters were observed.Results Among patients with RA-SS,there were 24 cases （5 1.1%）RA-onset SS,4 cases （8.5%）SS-onset RA and 14 （40.4%）cases with simultaneous-onset RA and SS.Compared with RA without SS,the patients with RA-SS were younger and showed a higher incidence of weakness, xerostomia,xerophthalmia,leucopenia and lung involvement,a higher positive rate of ANAs,anti-SSA and anti-SSB antibodies,higher IgG and lower C4 and a lower positive rate of higher CRP.Compared with the pSS patients group, RA-SS patients had a longer disease duration,more severe arthritis,a higher incidence of morning stiffness,deformed joints anemia and lung involvement,a higher positive rate of RF,anti-CCP antibodies,higher level CRP and ESR,a lower incidence of weakness,xerostomia,xerophthalmia and leucopenia,a lower positive rate of ANAs,anti-SSA and anti-SSB antibodies.Conclusion RA-SS patients have distinct clinical and laboratory features which differed from those of RA or pSS patients.