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唾液腺超声对干燥综合征的诊断价值 被引量:2
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作者 刘杨 程昉 +3 位作者 王艳玲 艾香艳 朱振航 赵福涛 《北京大学学报(医学版)》 CAS CSCD 北大核心 2022年第6期1123-1127,共5页
目的:评估唾液腺超声(salivary gland uhrasonography, SGUS)对干燥综合征(Sjogren’s syndrome, SS)的诊断价值。方法:收集2019年12月至2022年1月就诊于上海交通大学医学院附属第九人民医院风湿免疫科门诊及住院部的246例表现为口干和... 目的:评估唾液腺超声(salivary gland uhrasonography, SGUS)对干燥综合征(Sjogren’s syndrome, SS)的诊断价值。方法:收集2019年12月至2022年1月就诊于上海交通大学医学院附属第九人民医院风湿免疫科门诊及住院部的246例表现为口干和/或眼干燥的患者,均完善SGUS,并采用2019年风湿病临床试验结果指标(outcome measures in rheumatology clinical trial, OMERACT)工作组超声评分系统对患者唾液腺进行评分,记录患者一般资料、未刺激唾液流率(unstimulated saliva flow rate, USFR)、Schirmer试验及血清学检查结果,193例完善唇腺活检检查。采用2016年美国风湿病学会(American College of Rheumatology, ACR)/欧洲抗风湿病联盟(European League Against Rheumatism, EULAR)共识作为SS诊断金标准。采用χ^(2)检验比较两组唾液腺超声评分的差异,用受试者工作特征(receiver operating characteristic, ROC)曲线评估SGUS诊断SS的准确性,并比较SS患者中SGUS阳性组与阴性组的临床特征。结果:共175例患者符合2016年ACR/EULAR共识为SS组,余71例不符合ACR/EULAR共识为非SS患者,两组患者年龄[(54.2±11.8)岁vs.(53.4±14.9)岁,P=0.705]、女性(94.4%vs.93.1%,P=1.000)比较差异均无统计学意义。共109例患者SGUS阳性(≥2分),其中104例符合SS诊断,5例不符合SS诊断,SS组SGUS阳性率明显高于非SS组(59.4%vs.7.0%,P<0.001)。2019年OMERACT超声评分系统诊断SS的曲线下面积为0.762(95%CI 0.701~0.823), SGUS评分与ACR/EULAR共识的绝对一致性为69.1%(170/246),敏感性为59.4%(104/175),特异性为93.0%(66/71),阳性预测值为95.4%(104/109),阴性预测值为48.2%(66/137)。共81例患者SGUS、抗干燥综合征A (Sjogren’s syndrome A, SSA)抗体双阳性,均符合ACR/EULAR共识,阳性符合率为100%(81/81);85例患者SGUS阴性且无抗SSA抗体,60例未达到ACR/EULAR共识,阴性符合率为70.6%(60/85)。在SS患者中,SGUS阳性组有更高的抗核抗体(antinuclear antibody, ANA)阳性率(83.1%对98.1%,P<0.001)。结论:2019年OMERACT超声评分系统在诊断SS中有重要价值,与抗SSA抗体联合可进一步提高诊断性能。 展开更多
关键词 干燥综合征 唾液腺 超声
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涎腺超声对原发性干燥综合征的诊断和评估价值 被引量:2
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作者 刘杨 程昉 +3 位作者 王艳玲 艾香艳 朱振航 赵福涛 《中华临床免疫和变态反应杂志》 CAS 2021年第5期528-533,共6页
目的探讨涎腺超声(salivary gland ultrasonography,SGUS)对原发性干燥综合征的(primary Sjogren s syndrome,pSS)诊断和评估价值。方法收集本院风湿免疫科住院及门诊96例pSS患者及58例表现为口干和/或眼干燥的非pSS患者,采用实质不均性... 目的探讨涎腺超声(salivary gland ultrasonography,SGUS)对原发性干燥综合征的(primary Sjogren s syndrome,pSS)诊断和评估价值。方法收集本院风湿免疫科住院及门诊96例pSS患者及58例表现为口干和/或眼干燥的非pSS患者,采用实质不均性0~12分级系统对其进行评分。比较两组SGUS评分的差异并分析其诊断pSS的价值。结果pSS组SGUS评分高于非pSS组[M(IQR):8(2)vs.0(2),P<0.001]。SGUS评分诊断pSS的曲线下面积为0.868(95%置信区间0.807~0.929),以6分做为截断值,敏感性为81.3%(78/96),特异性为89.6%(52/58);阳性预测值为92.9%(78/84),阴性预测值为74.3%(52/70)。抗核抗体、抗SSA抗体、唾液流率与SGUS评分相关(P<0.05),且唾液流率为SGUS评分的独立危险因素(P=0.003)。结论SGUS实质不均性分级系统(0~12)简便、易操作,在诊断pSS中有重要价值。 展开更多
关键词 原发性干燥综合征 涎腺超声 实质不均性
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Coexistence of Th1/Th2 and Thl7/Treg imbalances in patients with allergic asthma 被引量:122
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作者 SHI Yu-heng SHI Guo-chao +7 位作者 WAN Huan-ying JIANG Li-hua ai xiang-yan ZHU Hai-xing TANG Wei MA Jia-yun JIN Xiao-yan ZHANG Bo-ying 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第13期1951-1956,共6页
Background Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4^+ T cells subsets might play a role in asthma. We investigated the relative abundance and activit... Background Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4^+ T cells subsets might play a role in asthma. We investigated the relative abundance and activities of Thl, Th2, Th17 and CD4^+CD25^+ Treg cells in patients with allergic asthma. Methods Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma and 20 healthy donors were enrolled. All patients were allergic to house dust mites. Plasma total IgE, pulmonary function and Asthma Control Questionnaire were assessed. The proportions of peripheral blood Thl, Th2, Th17 and CD4^+CD25^+ Treg cells were determined by flow cytometry. The expression of cytokines in plasma and Jn the culture supernatant of peripheral blood mononuclear cells was determined by enzyme linked, immunosorbent assay. Results The frequency of blood Th2 cells and IL-4 levels in plasma and culture supernatant of peripheral blood mononuclear cells were increased in all patients with allergic asthma. The frequency of Th17 cells and the plasma and culture supernatant levels of IL-17 were increased, whereas the frequency of CD4^+CD25^+ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. Dermatophagoides pteronyssinus specific IgE levels were positively correlated with the percentage of blood Th2 cells and plasma IL-4 levels. Forced expiratory volume in the first second was negatively correlated with the frequency of Th17 cells and plasma IL-17 levels, and positively correlated with the frequency of Treg cells. However, mean Asthma Control Questionnaire scores were positively correlated with the frequency of Th17 cells and plasma IL-17 levels, and negatively correlated with the frequency of Treg cells. Conclusions Imbalances in Thl/Th2 and Th17/Treg were found in patients with allergic asthma. Furthermore, elevated Th17 cell responses, the absence of Tregs and an imbalance in Th17/Treg levels were associated with moderate to severe asthma. 展开更多
关键词 allergic asthma Thl cells Th2 cells Thl 7 cells regulatory T cells
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An increased ratio of Th2/Treg cells in patients with moderate to severe asthma 被引量:9
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作者 SHI Yu-heng SHI Guo-chao +6 位作者 WAN Huan-ying ai xiang-yan ZHU Hai-xing TANG Wei MA Jia-yun JIN Xiao-yan ZHANG Bo-ying 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第12期2248-2253,共6页
Background Recent studies have shown that T helper type-2 (Th2) cells can induce the apoptosis of CD4+CD25+ Treg cells or resist the immunosuppressive effect of Treg cells. We hypothesize that an imbalance of Th2/... Background Recent studies have shown that T helper type-2 (Th2) cells can induce the apoptosis of CD4+CD25+ Treg cells or resist the immunosuppressive effect of Treg cells. We hypothesize that an imbalance of Th2/Treg is present in patients with allergic asthma. Methods Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma, and 20 healthy donors were enrolled. All patients were allergic to house dust mites. The proportion of peripheral blood CD4+CD25+ Treg cells and Th2 cells were determined by flow cytometry. The concentration of interleukin (IL)-10, transforming growth factor (TGF) -βand tL-4 in plasma was determined by enzyme linked immunosorbent assay. In these subjects, peripheral blood mononuclear cells from 17 mild asthmatic patients, 13 moderate to severe asthmatic patients and 14 healthy donors were acquired and expression of forkhead box P3 (Foxp3) and GATA-3 mRNA was detected by reverse-transcriptase polymerase chain reaction. Results Compared with healthy donors and patients with mild asthma, the percent of CD4+CD25+ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. There were no significant differences in Foxp3 mRNA expression among three groups, but a downward trend seen among patients with asthma. However, the percent of Th2 cells, IL-4 levels and expression of GATA-3 mRNA was markedly higher in patients with mild and moderate to severe asthma than in the control group. The ratio of Th2/Treg and their cytokines was increased in allergic asthma, especially for moderate to severe asthma. The ratio of GATA-3/Foxp3 mRNA was also increased in allergic asthma. In patients with moderate to severe asthma, the percentage of peripheral blood Treg cells was negatively correlated to the percentage of Th2 cells and IL-4 levels. Conclusions The decline of CD4+CD25+ Treg cells in patients with moderate to severe asthma may play an important role in progress of the disease. Furthermore, the deficiency of CD4+CD25+ Treg cells was associated with the overexpression of Th2 response. 展开更多
关键词 allergic asthma Th2 cells regulatory T cells
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