目的:系统性硬化症(SSc)是一种多器官破坏的自身免疫性疾病。这项研究旨在确定埃及硬皮病患者主要唾液腺的超声变化,并检测其与不同疾病表现的关联。
方法:纳入47例SSc患者和43例表观健康志愿者。人口统计,炎症标志物,并记录自身免疫状态。对唾液腺进行超声评估。统计检查了唾液腺变化与SSc易感性和疾病表现的关联。
结果:31例SSc患者表现为腺体病理(p<0.0001),与对照组相比。在这些异常中,与对照组相比,SSc患者在p<0.0001时,腮腺总灰度为2,颌下总灰度为2,腺体总灰度为4,腺体总多普勒信号为1。SSc和腺体病理患者的关节炎患病率(p=0.029)和ESR(p=0.002)高于正常腺体超声患者。据报道,全腮腺的灰度超声(GSUS)之间存在显着关联(比值比“OR”=0.4),下颌下总(OR=0.36),和总腺体(OR=0.53),对SSc的敏感性p<0.0001。总腺体GSUS(p=0.039)和总下颌下功率多普勒(p=0.044)与SSc持续时间相关。总腮腺GSUS(p=0.008)和总腺体GSUS(p<0.0001)与Schirmer检验相关。
结论:SSc主要唾液腺受累。因此,扫描这些腺体与超声波是一个添加剂的工具,除了目前的做法。重点•唾液腺的主要变化,通过超声观察,是埃及SSc患者的新发现。•主要唾液腺的超声改变与炎症标志物和SSc的临床表现有关。•硬皮病主要唾液腺的超声扫描可以添加到常规工作中。
OBJECTIVE: systemic sclerosis (SSc) is an autoimmune disorder with multiple organs destruction. This study aimed to identify the ultrasonographic changes of major salivary glands in Egyptian scleroderma patients and to detect their association to different disease manifestations.
METHODS: Forty-seven SSc patients and 43 apparent healthy volunteers were enrolled. Demographics, inflammatory markers, and autoimmune status were recorded. Ultrasound evaluation of salivary glands was performed. Salivary gland changes\' associations were statistically examined with SSc susceptibility and disease manifestations.
RESULTS: Thirty-one SSc patients exhibited glandular pathology (p < 0.0001), compared to controls. Of these abnormalities, SSc patients showed a total parotid gray scale of 2, total
submandibular gray scale of 2, total glandular gray scale of 4, and total glandular Doppler signal of 1 at p < 0.0001, compared to the control group. Patients with SSc and glandular pathology had a higher prevalence of arthritis (p = 0.029) and ESR (p = 0.002) than those with normal glandular ultrasound. Significant associations were reported between gray scale ultrasound (GSUS) of total parotid (odds ratio \"OR\" = 0.4), total
submandibular (OR = 0.36), and total glandular (OR = 0.53) with susceptibility to SSc at p < 0.0001. Total glandular GSUS (p = 0.039) and total
submandibular power Doppler (p = 0.044) correlated with the SSc duration. Total parotid GSUS (p = 0.008) and total glandular GSUS (p < 0.0001) correlated with Schirmer\'s test.
CONCLUSIONS: Major salivary glands are affected in SSc. Hence, scanning these glands with ultrasound is an additive tool besides the current practice. Key Points • Major salivary gland changes, observed by ultrasonography, are new findings in Egyptian SSc patients. • Ultrasound changes of major salivary glands are associated with inflammatory markers and clinical manifestations of SSc. • Scleroderma ultrasonography scans of the main salivary glands could be added to the routine work.