唾液腺超声评分法诊断干燥综合征的价值

摘要

目的 探讨唾液腺超声评分法对干燥综合征(SS)的诊断价值.方法 收集我院风湿免疫科门诊或住院的口干、眼干患者92例,将患者分为SS组42例和非SS组50例.对所有患者双侧腮腺及颌下腺进行二维超声检查,获得双侧腮腺及颌下腺的声像图,采用半定量评分方法对其进行评分.比较两组唾液腺超声评分的差异并分析其诊断SS的价值.结果 非SS组中38例(38/50,76.00％)唾液腺超声表现正常,评为0分,SS组32例(32/42,76.19％)唾液腺超声评分≥1分.SS组唾液腺超声评分高于非SS组(P＜0.001).唾液腺超声评分诊断SS的ROC曲线下面积为0.805[P＜0.001,95％可信区间(0.711,0.899)],以2分为临界值诊断SS敏感度为59.5％,特异度为92.0％.结论 唾液腺超声评分法可为唾液腺回声的均匀程度提供半定量指标,在诊断SS中有重要价值.%Objective To explore the value of salivary glands ultrasonography in diagnosis of Sj(o)gren's syndrome (SS).Methods Ninety-two patients with symptoms of xerophthalmia or xerostomia were enrolled,and 42 of them were divided to the SS group and the others to non-SS group.The bilateral parotid and submandibular gland of all patients were examined with ultrasonography,then the ultrasonographic features of bilateral salivary glands were obtained.The imaging features of salivary glands were evaluated by a semi-quantitative scoring system.The differences of ultrasonography scores between SS group and non-SS group were compared.The value of semi-quantitative scoring system in diagnosis of SS was analyzed.Results Salivary gland ultrasonic manifestations of 38 patients (38/50,76.00％) in non-SS group were normal,whose ultrasonographic scores were 0.Whereas the ultrasound of 32 patients (32/42,76.19％) were abnormalities in SS group,whose ultrasonographic scores were ≥1.Ultrasonographic scores in SS group were higher than that of non-SS group (P＜0.001).The area under the ROC curve of ultrasound score in diagnosis of SS was 0.805 (P＜0.001,95％ confidence interval was [0.711,0.899]).When the cutoff value of the scores was 2,the sensitivity and specificity were 59.5 ％,and 92.0％.Conclusion The ultrasonographic scoring of salivary glands can provide a semi-quantitative index for inhomogeneity of the salivary glands,which has significant value in the diagnosis of SS.