唾液电解质测定对干燥综合征的诊断价值

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目的通过研究干燥综合征(SS)及其他对照组患者唾液Na+、K+浓度,比值和单位时间总量的变化及相互关系,来寻求一种新的SS鉴别诊断的方法。方法①根据SS、类风湿关节炎(RA)和系统性红斑狼疮(SLE)的诊断标准,将病人分为SS组,RA组,SLE组,单纯性口干组,正常对照组,共5组。②利用混合唾液采取法采集5组唾液标本,应用离子选择电极电位测定分析法测定其唾液Na+、K+浓度,计算出比值和单位时间分泌总量,精密pH试纸测pH值。③分别用t检验和单因素方差分析进行组间比较。结果SS组的唾液Na+浓度和Na+/K+的比值明显高于RA组、SLE组、单纯性口干组及对照组(P<0.001);SS组与RA组、SLE组和对照组比较唾液K+分泌总量显著降低(P<0.01,P<0.001)。由此可见应用敏感性(87.5%)和特异性(91.4%)较高的Na+浓度及特异性(97.9%)高而敏感性(75%)一般的Na+/K+比值来鉴别SS与其他风湿性免疫疾病及单纯性口干具有较高的临床诊断价值。单位时间内K+含量特异性(89.7%)虽然较高,但因敏感性(67.5%)偏低,故可将其用于SS的初步筛选。结论唾液电解质的测定是一种方便、准确、经济的实验方法,有可能成为鉴别诊断SS综合征的指标之一。 Objective To search for a new method for differential diagnosis of SS by studying the changes of saliva Na +, K + concentration, ratio and the total amount of saliva per unit time in patients with Sjogren’s syndrome (SS) and other control groups. Methods ① According to the diagnostic criteria of SS, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), the patients were divided into SS group, RA group, SLE group, simple dry mouth group and normal control group . (2) Five groups of saliva samples were collected by mixed saliva method. The concentrations of Na + and K + in saliva were determined by ion-selective electrode potential assay. The ratio and the total amount of saliva per unit time were calculated. ③ t-test and one-way analysis of variance were used to compare between groups. Results The ratio of saliva Na + concentration and Na + / K + in SS group was significantly higher than that in RA group, SLE group, simple dry mouth group and control group (P <0.001). Compared with RA group, SLE group and control group, The total amount of secretion was significantly lower (P <0.01, P <0.001). From this we can see that the Na + / K + ratio of high Na + concentration and specificity (97.9%) and sensitivity (75%) with high sensitivity (87.5%) and specificity (91.4%) were used to identify SS and other rheumatic Immune diseases and simple dry mouth have a higher clinical diagnostic value. Although the K + content specificity (89.7%) per unit time was high, it could be used for primary screening of SS due to its low sensitivity (67.5%). Conclusion Determination of salivary electrolytes is a convenient, accurate and economical experimental method, which may become one of the indicators of differential diagnosis of SS syndrome.
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