涎腺超声联合血清BAFF检测在原发性干燥综合征诊断中的价值

摘要

Objective To assess the value of serum BAFF level combined with salivary gland ultrasonography in diagnosis of primary Sjogren's syndrome (pSS).Methods The serum levels of BAFF,APRIL,TNF-a,IL-1 β and IL-6 were measured by ELISA in 80 pSS patients,60 rheumatoid arthritis(RA) patients and 60 healthy controls.Salivary gland was examined with two-dimensional ultrasonography in three groups.The correlation of serum levels of BAFF,APRIL,TNF-α,IL-1 β,IL-6 and salivary gland ultrasonography with pSS was evaluated.Results The serum levels of BAFF,IL-1 β,TNF-o in pSS patients were significantly higher than those in RA patients and healthy controls (all P＜0.05),while there were no significant differences in serum levels of APRIL and IL-6 among tree groups.The salivary gland ultrasound scores was negatively correlated with serum BAFF level (r=-0.462,P＜0.05) and positively correlated with IL-1 β level (r=0.403,P＜0.05).The sensitivity of salivary ultrasonography in diagnosis of pSS was higher than that of SSA/SSB and the specificity was similar.The sensitivity of serum BAFF in diagnosis of pSS was higher than that of SSA/SSB,but the specificity was lower.For pSS patients with ultrasonic score ＜ 2min,the specificity of ultrasonography combined with BAFF was increased to 96.77％.Conclusion Serum BAFF measurement combined with salivary gland ultrasound examination can be used for screening and diagnosis of primary Sjogren's syndrome.%目的 探讨涎腺超声联合血清B淋巴细胞刺激因子(BAFF)检测在原发性干燥综合征(pSS)诊断中的临床价值.方法 选择pSS患者80例(pSS组),类风湿关节炎(RA)患者60例(RA组),健康体检者20例(健康对照组).采用ELISA法检测各组血清BAFF、增殖诱导配体(APRIL)、TNF-a、IL-1β及IL-6水平;通过二维超声评估pSS患者涎腺受累情况.分析比较各组血清BAFF、APRIL、TNF-a 、IL-1 B、IL-6水平,并分析pSS患者血清BAFF、APRIL、TNF-a、IL-1β 、IL-6与涎腺超声评分的相关性.结果 3组血清BAFF、IL-1 β、TNF-a比较差异均有统计学意义(均P＜0.05),其中pSS组患者血清BAFF、IL-1 β、TNF-a水平明显高于RA组与健康对照组,差异均有统计学意义(均P＜0.05).pSS患者血清BAFF与涎腺评分呈负相关(r=-0.462,P＜0.05),血清IL-1 β与涎腺评分呈正相关(r=0.403,P＜ 0.05).涎腺超声、血清BAFF对pSS诊断的灵敏度高于抗干燥综合征A抗原(SSA)/干燥综合征B抗原(SSB)、类风湿因子(RF),差异均有统计学意义(均P＜0.05).对于涎腺超声评分≤2分的早期pSS患者,涎腺超声联合BAFF检测诊断特异度达到96.77％.结论 pSS患者血清BAFF在疾病的早期即有明显升高,有助于早期诊断.涎腺超声对pSS的诊断比抗SSA/sSB有更高的灵敏度,特异度相当;BAFF对pSS的诊断比抗SSA/sSB灵敏度高,但特异度较低.对于涎腺超声评分≤2分的pSS患者,涎腺超声联合血清BAFF检测可提高诊断的特异度,可作为早期筛查指标.