弹性成像结合抗Ro-SSA抗体、抗La-SSB抗体在诊断原发性干燥综合征（pSS）中的应用

发布时间：2018-04-14 06:23

本文选题：弹性成像 + 原发性干燥综合征(pSS)　；参考：《兰州大学》2015年硕士论文

【摘要】：目的原发性干燥综合征(primary Sjogren's syndrome pSS)是较为常见的自身免疫性疾病之一,除眼干及口干等症状之外,有相当一部分患者有其他系统的累及。由于症状不典型,分类标准的灵敏度及特异度对于原发性干燥综合征(pSS)的早期诊断及后续治疗显得尤为重要。本课题旨在评价高频超声及弹性成像技术结合抗Ro-SSA抗体、抗La-SSB抗体对于原发性干燥综合征(pSS)的诊断价值,为新的检查手段及新的分类标准的提出给予一定帮助。方法选取从2012年3月份至2015年2月在我院风湿科住院及门诊疑有原发性干燥综合征(pSS)的44例患者,对其双侧腮腺及颌下腺行常规超声检查及弹性成像检查,并同时检测患者抗Ro-SSA抗体、抗La-SSB抗体,入组病例均有唇腺活检结果。其中女35例,男9例；年龄21-58岁,平均年龄32岁。入组标准：患者有口干或眼干症状或因其他症状使临床疑有原发性干燥综合征(pSS)患者。排除标准：伴有其他结缔组织疾病、头颈面部放射治疗史、丙肝病毒感染、人类免疫缺陷病毒(HIV)或获得性免疫缺陷综合征(AIDS)、淋巴瘤、结节病、移植物抗宿主病和抗胆碱能药物的使用。诊断标准：以AECG分类标准(2002)作为判定标准。运用前进法二分类Logistic回归分析,对高频灰阶超声评分、抗Ro-SSA抗体、抗La-SSB抗体、唇腺活检及弹性SR值等变量赋值。结果44例患者中27例诊断有原发性干燥综合征(pSS),17例结果为阴性。前进法二分类Logistic回归分析筛选出在原发性干燥综合征(pSS)诊断中有统计学意义的特征变量包括抗Ro-SSA抗体、抗La-SSB抗体及弹性应变率(SR比值)。所建立的回归模型为Logit(P)=-7.275+2.743X2+2.993X4,方程对原发性干燥综合征(pSS)预报的正确率为93.2%。结论弹性成像技术结合抗Ro-SSA抗体、抗La-SSB抗体在原发性干燥综合征(pSS)的诊断中具有较高的价值,所建立的Logistic回归模型具有较高的诊断正确率。
[Abstract]:Objective Primary Sjogren's syndrome pSSs is one of the most common autoimmune diseases. In addition to dry eye and dry mouth, a large number of patients have other systemic involvement.Due to atypical symptoms, the sensitivity and specificity of classification criteria are very important for the early diagnosis and subsequent treatment of primary Sjogren's syndrome (PSS).The purpose of this study was to evaluate the diagnostic value of high frequency ultrasound and elastic imaging combined with anti Ro-SSA antibody and anti La-SSB antibody in the diagnosis of primary Sjogren's syndrome (PSS).Methods from March 2012 to February 2015, 44 patients with suspected primary Sjogren's syndrome (PSS) were examined by conventional ultrasonography and elastic imaging.At the same time, we detected the anti-Ro-SSA antibody, anti-La-SSB antibody and labial gland biopsy results.Among them, 35 cases were female, 9 cases were male, the age was 21-58 years old, the average age was 32 years old.Admission criteria: patients with dry mouth or dry eye symptoms or clinically suspected with primary Sjogren's syndrome (PSS) due to other symptoms.Exclusion criteria: with other connective tissue diseases, history of head, neck and face radiotherapy, hepatitis C virus infection, human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDSI), lymphoma, sarcoidosis,Graft versus host disease and use of anticholinergic drugs.Diagnostic criteria: AECG classification criteria / 2002) as the criteria.By using the advanced two-classification Logistic regression analysis, the scores of high-frequency gray-scale ultrasound, anti- antibody, anti- antibody, labial gland biopsy and elastic SR value were evaluated.Results among 44 cases, 27 cases were diagnosed with primary Sjogren's syndrome and 17 cases were negative.Advanced two-classification Logistic regression analysis showed that the characteristic variables in the diagnosis of primary Sjogren's syndrome (PSS) included anti Ro-SSA antibody, anti La-SSB antibody and the ratio of elastic strain rate to SR.The established regression model is Logit(P)=-7.275 2.743X2 2.993X4, and the accuracy of the equation for prediction of primary Sjogren's syndrome (PSS) is 93.2%.Conclusion Elastic imaging combined with anti Ro-SSA antibody and anti La-SSB antibody are valuable in the diagnosis of primary Sjogren's syndrome (PSS). The established Logistic regression model has a high diagnostic accuracy.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.1;R593.2

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