摘要
目的探讨儿童干燥综合征(SS)的临床特点,提高对儿童SS的认识。方法回顾性分析本院2003年7月-2009年3月住院诊治的17例儿童SS临床特点。结果首发症状为腮腺大者7例,关节痛者5例,口干者2例,紫癜者2例,肾小管酸中毒(RTA)者1例。在整个病程中,反复腮腺大(13/17例)、关节痛(8/17例)较多;口干(10/17例)、眼干(5/17例)表现亦不少,但早期不明显。RTA(9/17例),但临床症状多不明显,往往是在尿常规、血生化等检测异常后发现。实验室检查:抗SSA(17/17例)、抗SSB(17/17例)、类风湿因子(RF)(15/15例)、抗核抗体(ANA)(16/16例)检测均呈阳性;IgG(9/10例)水平较高;其中腮腺造影者6例,泪液分泌试验者9例,均呈阳性。结论儿童SS有以下特点:1.主要表现为反复腮腺大、RTA、关节痛明显,口干、眼干者不少,但早期不明显。2.与成人比较,除肾脏外,其他脏器受累相对较少。3.血清抗SSA、抗SSB、RF、ANA阳性率及IgG水平均较高。4.腮腺造影及泪液分泌试验有利于儿童SS诊断。5.SS患儿的预后目前尚不清楚,需长期随访。
Objective To recognize the Sjogren＇s syndrome （SS） by assessing the clinical features of SS in children. Method Data from 17 childhood patients with definite SS were analyzed retrospectively. Results Initial clinical symptoms such as parotid swelling（ 7 eases ） , arthralgia （ 5 cases） , dry mouth （ 2 cases） , rush （ 2 cases） , renalis tubulus acidosis （RTA） （ 1 case） , were very common in childhood. The frequency of parotid swelling（13/17 cases）, arthralgia（8/17 cases）was high. Dry mouth（ 10/17 cases）and dry eyes（5/17 cases）were also commonly seen, and SS, however, had a period of delitescence and its earlier symptoms were not obvious. RTA were also common, but its clinical symptoms were not obvious, which could be diagnosed after the abnormalities in urine analysis and blood biochemistry analysis were done. Lab findings indicated higher levels of Anti - SSA（ 17/17 cases） ,anti - SSB（ 17/17 cases） ,serum rheumatoid factor（RF） （ 15/15 cases） ,anti - nuclear antibody （ ANA ） （ 16/16 cases） , IgG （9/10 cases） in all patients. Six patients had parotid sialography abnormalitis and 9 cases had Sehirmer test abnormalities. Conclusions The major clinical characteristics of childhood SS cases were included ： 1. parotid swelling, RTA, arthralgia which appeared earlier. Dry mouth and dry eyes were also common. 2. Besides the kidney, the frequency of other organ abnormalities were less commonly seen than adult. 3. Anti - SSA, anti - SSB, RF, ANA, IgG were higher. 4. Parotid sialography and SchirmerItest are useful for the diagnosis of SS in children. 5. The prognosis of SS in childhood is unclear now, and a long - term follow - up is needed.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第21期1663-1664,1671,共3页
Journal of Applied Clinical Pediatrics
关键词
干燥综合征
临床特点
儿童
Sjogren＇s syndrome
clinical features
child
