超声是检查干燥综合征患者唾液腺病变的有用工具

作者：Sandrine Jousse-Joulin,et al.

翻译：丁艳

摘要：目的：超声（US）是诊断原发性干燥综合征（pSS）患者唾液腺异常的敏感工具。系统回顾研究目的在于评估超声检查的评价指标。

方法：本研究检索了 PUBMED和 EMBASE数据库1988年1月至2013年1月发表的所有文章，根据液腺超声评分系统及评价指标的定义，将符合标准的数据纳入该项研究。对检测腺体的种类及数目、研究设计和评价指标的评估均遵循风风湿病学临床试验终点指标测定任务小组（OMERACT）的原则（真实、创新、可行）。

结果：PUBMED和EMBASE数据库的167项研究中，仅31项研究符合入选标准。原发性干燥综合征患者的样本量从16到140例，各不相同。干燥综合征患者根据美欧联合组织（AECG）的分类标准进行诊断。超声检查在可疑原发干燥综合征患者中的敏感性为45.8%－91.6%，特异性为73%－98.1%。采用B超检查与彩色多普勒检查的研究存在一些差异。极少有研究报道超声检查的可靠性及其在干燥综合征患者中的检查差异。

结论：超声是检查原发性干燥综合征患者唾液腺病变的一种有价值的工具。其可靠性目前报道较少，同时对于超声检查异常的描述存在较大差异。需要进一步的研究来进一步验证及规范干燥综合征患者唾液腺超声检查的标准。

附原文：Objective. Ultrasonography (US) is a sensitive tool in the diagnosis of major salivary gland abnormalities in primary Sj?gren’s syndrome (pSS). The aim of this systematic review was to assess the metric properties of this technique.Methods. PUBMED and EMBASE databases were searched. All publications between January 1988 and January 2013 were considered. Data were extracted from the articles meeting the inclusion criteria according to US definition of salivary gland scoring system and metric properties studied. The type and number of glands tested, study design and metric properties according to OMERACT filter (truth, discrimination, feasibility) were assessed. Results. Of 167 publications identified initially with PUBMED and EMBASE, 31 met the inclusion criteria. The number of pSS patients varied among the studies from 16 to 140. The diagnosis of pSS was in line in most of the cases with the American–European Consensus Group (AECG) classification criteria for Sj?gren’s syndrome. The US examination was performed in suspected pSS only in studies in which the sensitivity ranged from 45.8 to 91.6% and specificity from 73 to 98.1%. There was heterogeneity in regard to the definition of US in B-mode and few studies used US in colour Doppler. Few studies reported reliability of US and sensitivity to change in pSS.Conclusion. US is a valuable tool for detecting salivary gland abnormalities in pSS. Its reliability has been poorly investigated and there is considerable variation in the definition of US abnormalities. Further studies are required to validate and standardize the US definition of salivary gland in pSS.

引自：Sandrine Jousse-Joulin, Vera Milic, Malin V. Jonsson, and on behalf of the US-pSS Study Group. Is salivary gland ultrasonography a useful tool in Sj?gren’s syndrome? A systematic review. Rheumatology ,2016, 55 (5): 789-800.