以消化道症状为首发表现的干燥综合征9例报道

Sjogren's syndrome firstly manifested as digestive tract symptoms:9 cases report

目的探讨以消化道为首发表现的干燥综合征（Sjogren’S syndrome，SS）患者的临床特点、误诊原因和防范措施。方法回顾性分析解放军八十九医院2014年1月-2015年10月收治的9例ss患者的临床资料。结果本组患者病程2～13年，主要表现为胸骨后不适、吞咽哽咽感、上腹部饱胀、上腹疼痛、便秘；部分伴有口干、眼干、不规则龋齿、皮肤干燥、关节疼痛、腮腺肿大、肝功异常；早期均漏诊、误诊，对症治疗效果不佳，后经专科检查确诊为SS。结论以消化道症状起病的ss极易误诊，仔细询问病史、系统全面的体格检查、综合分析病情、仔细鉴别诊断是减少误诊、漏诊的关键。

Objective To evaluate the clinical features, misdiagnosis and prevention measures of 5iogren＇ s syndrome （$S） firstly manifested as digestive tract symptoms. Methods The clinical data of 9 SS patients from Jan. 2014 to Oct. 2015 in 89 Hospital of PLA were retrospectively analyzed. Results The course of 9 SS patients was 2 - 13 years. Chest pain, swallowing, choking sensation, abdominal fullness, upper abdominal pain, constipation were the main performance; Section to dry mouth, dry eyes, irregular dental caries, dry skin, joint pain, swelling of the parotid gland, abnormal liver function were the clinical manifestations; all 9 SS patients were misdiagnosed with poor symptomatic treatment, finally they were diagnosed as SS by specialist. Conclusion SS is easily misdiagnosed as gastrointestinal diseases. The key to reduce the misdiagnosis is careful medical history taking, completely physical examination, comprehensive analysis of the disease,and careful in differential diagnosis.