112例原发性干燥综合征合并血液系统损害的临床及免疫学特征分析

摘要

目的：探讨原发性干燥综合征（ primary sjogren′s syndrome，pSS）血液系统损害的临床及其免疫学特点。方法：回顾性分析112例合并血液系统损害pSS患者的临床表现、实验室检查、骨髓象检查及疾病的转归，并与134例未合并血液系统损害pSS患者临床资料进行对比分析，计量资料采用t检验，计数资料采用χ2检验。结果：112例合并血液系统改变的pSS患者，贫血59例（52．7％），血小板减少21例（18．8％），白细胞减少32例（28．5％）；两系受累18例（16．1％），三系受累4例（3．6％）。 pSS合并血液系统损害组抗SSA抗体阳性率高于无血液系统损害组。112例合并血液系统损害的pSS患者中，97例（86．6％）骨髓检查显示异常。结论：抗SSA抗体可能与pSS的血液系统损害相关；pSS的血液系统损害中，以贫血最为常见，治疗后外周血及骨髓象均有不同程度的好转，其中贫血及白细胞减少患者的疗效较血小板减少的患者好。%Objective:To analyze the clinical and immunological characteristics for primary Sjogren′s syndrome(pSS).Methods:The clinical features, findings of laboratory test and bone marrow examination as well as outcomes were retrospectively analyzed in 112 cases of primary Sjogren′s syndrome asso-ciated with blood system damage,and the clinical data were compared with another PSS cases free of hematological damage.Then the results were estimated with t=test and χ2 test.Results:In 112 cases of primary Sjogren′s syndrome associated with hematological abnormality, anaemia was found in 59 (52.7%),thrombocytopenia in 21(18.8%),leucopenia in 32(28.5%),decreased count of Hb/WBC in 18(16.1%) and decreased count of Hb/PLT/WBC in 4(3.6%).The incidence with positive anti-SSA antibodies was higher in patients associated with hematological damages than that in those with normal blood cells.Ninety-seven (86.6%)of the 112 cases were found abnormal bone marrow.Conclusion:Hematological abnormality is involved in the anti-SSA antibody in PSS patients,and commonly characterized by anemia.After treatment,peripheral blood and bone marrow tend to be improved to a cer-tain degree,and prognosis seems better in patients with leucopenia than those with thrombopenia .