干燥综合征合并血清阴性脊柱关节病的临床特点及转归

摘要

Objective To improve the drying syndrome with seronegative spondyloarthropathies level of understanding and diagnosis. Methods 2005 one in 2011 at the Institute of rheumatology clinic syndrome complicated with seronegative disease in 13 cases patients general information, analysis of joint, mouth, eye and other clinical manifestations, line of labial salivary gland biopsy, corneal fluorescein staining, antinuclear antibody spectrum, HLA-B27, CT sacroiliac joint examination. Results The age is in 27-59 year old, average 45.7 years old, male 3 cases, female 10 cases. The cases in this group as the initial symptom of low back pain in 11 cases, peripheral joint pain in 9 cases, 5 cases of heel pain, dry mouth and dry eye in 10 cases, 8 cases of salivary gland biopsy, the positive rate was 84.6%(11/13), corneal fluorescein staining of abnormal 3.1.3%(3/13), the positive rate of Schirmer test in 30.8% (4/13), liquid flow rate test positive sex ratio of 30.8% (4/13), HLA-B27, anti SSA/ anti SSB(+), ANA(+)were 76.9%(10/13),69.2%(9/13),84.6%(11/13), the positive rate of CT 53.8%(7/13)sacroiliac joint. Conclusion Antinuclear antibodies, labial salivary gland biopsy, anti SSB antibody and HLA-B27, SSA, CT sacroiliac joint is adjunct diagnostic tool; two disease with clinically rare, timely diagnosis and treatment to improve the prognosis of patients with positive significance.%目的：提高对干燥综合征合并血清阴性脊柱关节病认识及诊断水平。方法收集2005至2011年在本院风湿免疫科就诊的干燥综合征合并血清阴性脊柱关节病13例患者的一般资料，分析关节、口、眼干，腰背痛等临床表现，行唇腺活检、角膜染色、泪膜破碎时间、Schirmer 试验、抗核抗体谱、HLA-B27、骶髂关节 CT 等检查。结果年龄在27~59岁，平均45.7岁，其中男性3例，女性10例。该组病例腰背痛11例，外周关节痛9例，足跟痛5例，口干10例，眼干8例，唇腺活检阳性率为84.6%（11/13），角膜染色异常3.1.3%（3/13）， Schirmer 试验阳性率30.8%（4/13），泪膜破碎时间3.1.3%（3/13），HLA-B27、抗 SSA/抗 SSB（+）、ANA（+）分别为76.9%（10/13），69.2%（9/13），84.6%（11/13），骶髂关节 CT 阳性率53.8%（7/13）。结论抗核抗体、Schirmer 试验、抗 SSB、SSA 抗体及 HLA-B27、骶髂关节 CT 等是辅助诊断手段；两病合并在临床上少见，及时诊断及治疗对改善患者预后有积极意义。