A Stratification Approach Based on Salivary Gland Ultrasonography for Assessing Secretory Function in Sjögren Disease.

IF 3.6 2区 医学 Q2 RHEUMATOLOGY
Wenke Huang, Shaoyun Hao, Zhiming Ouyang, Liqin Peng, Xinghuan Chen, Wenjing Yang, Wenjing Zhong, Junsheng Chen, Lie Dai, Yingqian Mo
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引用次数: 0

Abstract

Objective: Our aim was to develop an ultrasonographic scoring model for staging hypofunction of salivary glands (SGs) in patients with Sjögren disease (SjD).

Methods: The assessment of SG secretory hypofunction was conducted by measuring whole salivary flows. B-mode ultrasonography was performed bilaterally on the parotid and submandibular glands to quantitatively evaluate the gland score and Outcome Measures in Rheumatology (OMERACT) score. The correlation between these scores and SG secretory function in patients with SjD was analyzed, leading to the development of an ultrasonographic scoring model for staging SG hypofunction.

Results: A 1-center derivation cohort comprising 164 patients with SjD and a double-center validation cohort consisting of 107 patients with SjD were included. Both ultrasonographic scores demonstrated excellent discriminatory ability between patients with SjD with hypofunction and those with normal function (area under the curve > 0.8 for both; P < 0.001). A novel ultrasonographic scoring model revealed that low total OMERACT scores (< 5) indicated initial-stage SG hypofunction, whereas high scores (> 9) suggested end-stage hypofunction. Conversely, patients with moderate-level total OMERACT scores (5-9) required further stratification using total gland scores. The incidence of SG hypofunction among all 271 patients with SjD was found to be 18% in the initial stage, 58% in the progressive stage, and 100% in the end stage (P < 0.01). Further, the incidence of lacrimal gland involvement and hyperglobulinemia (IgG > 16 IU/mL) was significantly lower in the initial-stage patients compared to those at other stages (all P < 0.01).

Conclusion: The novel ultrasonographic scoring model incorporates precise definitions for each stage of SG hypofunction, providing a robust and clinically significant approach to stratification of SG secretory hypofunction in SjD.

基于唾液腺超声波检查的分层方法,用于评估斯约格伦病的分泌功能。
目的:我们的目的是建立一个超声评分模型,用于对斯约戈伦病患者的唾液腺(SG)功能减退进行分期:我们的目的是建立一个超声评分模型,用于对斯约格伦病(SjD)患者的唾液腺(SG)功能减退进行分期:方法:通过测量整个唾液流量来评估唾液腺分泌功能低下。对腮腺和颌下腺进行双侧 B 型超声波检查,定量评估腺体评分和 OMERACT 评分。分析了这些评分与 SjD 患者腮腺分泌功能之间的相关性,从而建立了一个用于腮腺分泌功能障碍分期的超声评分模型:结果:由164名SjD患者组成的单中心衍生队列和由107名SjD患者组成的双中心验证队列均包括在内。两种超声评分均显示出对功能减退和功能正常的 SjD 患者的极佳鉴别能力(AUC 均大于 0.8,p9),提示功能减退已进入晚期。相反,OMERACT 总分处于中等水平(5~9 分)的患者需要使用腺体总分进行进一步分层。在所有 271 名 SjD 患者中,SG 功能减退的发生率在初期为 18%,进展期为 58%,终末期为 100%(p16 IU/mL):新颖的超声评分模型包含每个阶段的精确定义,为SjD唾液腺分泌功能低下的分层提供了一种稳健且具有临床意义的方法。
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来源期刊
Journal of Rheumatology
Journal of Rheumatology 医学-风湿病学
CiteScore
6.50
自引率
5.10%
发文量
285
审稿时长
1 months
期刊介绍: The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.
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