IgG4相关唾液腺炎25例临床分析

Clinical analysis and differential diagnosis of 25 patients with IgG4-related sclerosing sialadenitis

目的:分析IgG4相关唾液腺炎和有"唾液腺肿大"类似表现的常见唾液腺非肿瘤疾病的特点,明确其临床鉴别诊断要点。方法:回顾分析诊断为IgG4相关唾液腺炎患者的临床资料,与有腺体肿大类似表现的唾液腺非肿瘤疾病进行比较,重点从病史及临床表现、血液免疫学和组织病理学方面比较IgG4相关唾液腺炎与舍格伦综合征(Sjogren’ssyndrome,SS)的差异,应用SAS8.0软件包对数据进行非参数统计。结果:335例唾液腺非肿瘤疾病患者纳入本研究,包括IgG4相关唾液腺炎25例、阻塞性唾液腺炎279例和SS31例。比较IgG4相关唾液腺炎与阻塞性唾液腺炎和SS的疾病特点可见,其在病史及临床检查、血液免疫学和组织病理学等方面均有各自特点,差异显著。结论:IgG4相关唾液腺炎是一类以唾液腺肿大为典型表现的唾液腺慢性炎症,临床上应综合多方面考虑,与其他可能引起唾液腺肿大症状的疾病明确鉴别,准确诊断,为进一步制订合理的治疗方案提供依据。

PURPOSE： To discuss the clinical features of Ig G4-related sclerosing sialadenitis and salivary glands nonneoplastic diseases presenting gland swelling, to make clear the key points of clinical differential diagnosis. METHODS：We retrospectively analyzed and compared the clinical data of Ig G4-related sclerosing sialadenitis with those of salivary glands non-neoplastic diseases especially Sjogren＇s syndrome（SS） in medical history, clinical examination, serology and pathology. The statistical analysis was performed using SAS 8.0 software package. RESULTS： Three hundred and thirtyfive patients with salivary glands non-neoplastic diseases were included in the study, including 25 Ig G4-related sclerosing sialadenitis, 279 obstructive sialadenitis and 31 SS. We compared Ig G4-related sclerosing sialadenitis with the others and found out significant differences in each aspects. CONCLUSIONS： Ig G4-related sclerosing sialadenitis is a kind of chronic salivary gland inflammation with glands swelling. In order to make a definite diagnosis with other salivary glands non-neoplastic diseases, a comprehensive analysis is needed.