本文選題：彈性成像 + 原發(fā)性干燥綜合征(pSS)�。� 參考：《蘭州大學(xué)》2015年碩士論文

【摘要】：目的原發(fā)性干燥綜合征(primary Sjogren's syndrome pSS)是較為常見的自身免疫性疾病之一,除眼干及口干等癥狀之外,有相當(dāng)一部分患者有其他系統(tǒng)的累及。由于癥狀不典型,分類標(biāo)準(zhǔn)的靈敏度及特異度對于原發(fā)性干燥綜合征(pSS)的早期診斷及后續(xù)治療顯得尤為重要。本課題旨在評價高頻超聲及彈性成像技術(shù)結(jié)合抗Ro-SSA抗體、抗La-SSB抗體對于原發(fā)性干燥綜合征(pSS)的診斷價值,為新的檢查手段及新的分類標(biāo)準(zhǔn)的提出給予一定幫助。方法選取從2012年3月份至2015年2月在我院風(fēng)濕科住院及門診疑有原發(fā)性干燥綜合征(pSS)的44例患者,對其雙側(cè)腮腺及頜下腺行常規(guī)超聲檢查及彈性成像檢查,并同時檢測患者抗Ro-SSA抗體、抗La-SSB抗體,入組病例均有唇腺活檢結(jié)果。其中女35例,男9例；年齡21-58歲,平均年齡32歲。入組標(biāo)準(zhǔn)：患者有口干或眼干癥狀或因其他癥狀使臨床疑有原發(fā)性干燥綜合征(pSS)患者。排除標(biāo)準(zhǔn)：伴有其他結(jié)締組織疾病、頭頸面部放射治療史、丙肝病毒感染、人類免疫缺陷病毒(HIV)或獲得性免疫缺陷綜合征(AIDS)、淋巴瘤、結(jié)節(jié)病、移植物抗宿主病和抗膽堿能藥物的使用。診斷標(biāo)準(zhǔn)：以AECG分類標(biāo)準(zhǔn)(2002)作為判定標(biāo)準(zhǔn)。運用前進(jìn)法二分類Logistic回歸分析,對高頻灰階超聲評分、抗Ro-SSA抗體、抗La-SSB抗體、唇腺活檢及彈性SR值等變量賦值。結(jié)果44例患者中27例診斷有原發(fā)性干燥綜合征(pSS),17例結(jié)果為陰性。前進(jìn)法二分類Logistic回歸分析篩選出在原發(fā)性干燥綜合征(pSS)診斷中有統(tǒng)計學(xué)意義的特征變量包括抗Ro-SSA抗體、抗La-SSB抗體及彈性應(yīng)變率(SR比值)。所建立的回歸模型為Logit(P)=-7.275+2.743X2+2.993X4,方程對原發(fā)性干燥綜合征(pSS)預(yù)報的正確率為93.2%。結(jié)論彈性成像技術(shù)結(jié)合抗Ro-SSA抗體、抗La-SSB抗體在原發(fā)性干燥綜合征(pSS)的診斷中具有較高的價值,所建立的Logistic回歸模型具有較高的診斷正確率。
[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.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R445.1;R593.2

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