唾液腺动态显像检测杨氏模量值正常的干燥综合征唾液腺损伤

摘要

目的 应用唾液腺动态显像评估杨氏模量值正常的干燥综合征(SS)患者腮腺及颌下腺的损伤情况.方法 分别收集78个SS与100个健康对照的腮腺及颌下腺的杨氏模量值,并采用两样本￡检验比较2组间的差异;绘制腮腺及颌下腺的杨氏模量值受试者工作特征(ROC)曲线,计算曲线下面积(AUC)与诊断界值;对SS腺体进行唾液腺动态显像,观察杨氏模量正常的SS腺体的15 min摄取分数(UR15).结果 SS患者与健康对照左、右两侧腮腺、颌下腺间杨氏模量值的差异均无统计学意义(t值:-1.192-0.404,均P＞0.05).SS腮腺的杨氏模量值高于正常腮腺[(15.39±8.08)和(9.33±2.21) kPa;t=7.169,P＜0.05].SS颌下腺的杨氏模量值高于正常颌下腺[(14.35±5.33)和(9.18±2.36) kPa;t=8.662,P＜0.05].腮腺及颌下腺杨氏模量值ROC曲线的AUC分别为0.78和0.83,各自以10.85 kPa及10.95 kPa为诊断界值,灵敏度分别为69.23％ (54/78)和73.08％(57/78),特异性分别为77.00％ (77/100)和83.00％ (83/100),阳性预测值分别为70.13％(54/77)和77.03％ (57/74),阴性预测值分别为76.24％ (77/101)和79.81％ (83/104).杨氏模量值与UR15评价SS腮腺、颌下腺的差异无统计学意义(x2值:0.963和0.896,均P＞0.05).78个SS腮腺与颌下腺的UR15值分别为1.42±0.97、1.19±0.83.约58.33％(14/24)杨氏模量值正常(＜10.85 kPa)的SS腮腺出现细胞摄取功能降低,约76.19％(16/21)杨氏模量值正常(＜10.95 kPa)的SS颌下腺出现细胞摄取功能降低.结论 SS患者腮腺与颌下腺硬度较健康对照增加且细胞功能受损,唾液腺动态显像可发现杨氏模量值正常的SS腺体的细胞功能受损.%Objective To evaluate the damage of the salivary gland in Sjogren's syndrome (SS)patients with normal Young's modulus value (YMV) using salivary gland dynamic imaging (SGDI).Methods A total of 78 parotid glands and submandibular glands of SS patients and 100 parotid glands and submandibular glands of healthy people were collected in this retrospective study.The difference of YMV between 2 groups was analyzed with two-sample t test;receiver operating characteristic (ROC) curves of YMV were drawn to calculate the area under carve (AUC) and cut-off values.SGDI was used to observe the uptake ratio of 15 min (UR15) value in the SS salivary glands with normal YMV.Results The YMV of left parotid/submandibular glands and right parotid/submandibular glands were not statistically different in both SS patients and healthy people (t values:from-1.192 to-0.404,all P＞0.05).The YMV of parotid/submandibular glands in SS patients was higher than that in healthy people:(15.39±8.08) vs (9.33±2.21) kPa,(14.35±5.33) vs (9.18±2.36) kPa (t values:7.169 and 8.662,both P＜0.05).ROC curves showed that the AUC of parotid glands and submandibular glands were 0.78 and 0.83.As the cut-off values of YMV were 10.85 kPa and 10.95 kPa,the sensitivity were 69.23％ (54/78) and 73.08％ (57/78),the specificity were 77.00％ (77/100) and 83.00％ (83/100),the positive predictive value were 70.13％ (54/77) and 77.03％ (57/74),the negative predictive value were 76.24％ (77/101) and 79.81％ (83/104),respectively.There was no statistically difference between YMV and UR15 for evaluating the SS parotid glands and submandibular glands (x2 values:0.963 and 0.896,both P＞0.05).The UR15 value of 78 SS parotid glands and submandibular glands were 1.42±0.97 and 1.19±0.83,respectively.About 58.33％ (14/24) parotid glands with normal YMV (＜10.85 kPa) and 76.19％ (16/21) submandibular glands with normal YMV (＜10.95 kPa)had reduced cellular uptake in SS patients.Conclusions Parotid glands and submandibular glands in SS patients are damaged,and the tissue hardness is increased.SGDI can discover the cellular damage in SS salivary glands with normal YMV.