| Objective: By comparing84cases the first symptom of primary sjogren syndromeclinical manifestations, routine laboratory tests, immunological parameters such differencesbetween patients, its incidence law, to provide a reference for clinical and further research.Methods: A retrospective analysis of our hospital from January2007–December2012inprimary sjogren’s syndrome patients’ clinical data was done. In the first symptom of groupinvolvement of the skin and mucous membranes, according to the first symptom, joint andmuscle involvement first symptom group, digestive affected first symptom group involvementin the group of the first symptom, blood system, respiratory system affected the first symptomgroup, urinary system affected the first symptom group, patients’ gender, age, clinicalmanifestations, routine laboratory parameters and immunological parameters were analyzed.Statistical methods were used to draw relevant conclusions. Results: According to the firstsymptom, patients were divided into six groups, skin and mucous membranes group (20cases); articular muscle group,13cases,15cases of the respiratory system; blood system,15cases; digestive system,11cases; ten cases of the urinary system.①Raynaud’s phenomenonand fever were more often appeared in Respiratory system symptom group than in othergroups. The difference was statistically significant (P <0.05); The incidence of mumps viruswas higher in Urinary symptom group than in other groups. The difference was notstatistically significant (P>0.05).②According to the incidence of the first clinical symptomsgroup to analyze the abnormal blood, there were significant differences in the incidence ofleucopenia in the first symptom of blood system and respiratory system symptom group.There was no significant difference in the incidence of leucopenia in other clinical symptomgroup (except the first symptom of blood system and respiratory system symptom group), thedifference was not statistically significant (P>0.05); The incidence of reducing hemoglobinwas higher in the first symptom of blood system group than in other groups, the difference was statistically significant (P <0.05); There was no significant difference in other groups(P>0.05). The incidence of reducing platelet was higher in the first symptom of blood systemgroup than in other groups, the difference was statistically significant (P <0.05), there was nosignificant difference in other groups (P>0.05).③The incidence of hematuria and proteinuriawas higher in urinary symptom group than in other groups, the difference was statisticallysignificant (P <0.05), there was no significant difference in other groups (P>0.05). Theincidence of creatinine, urea nitrogen levels was higher in urinary symptom group than inother groups, the difference was statistically significant (P <0.05), there was no significantdifference in other groups (P>0.05).④The incidence of aspartate aminotransferase andalanine aminotransferase was higher in the digestive system symptom group than in othergroups, the difference was statistically significant (P <0.05), there was no significantdifference in other groups (P>0.05). The incidence of low serum albumin was lower inmucocutaneous symptoms group than in other groups, the difference was statisticallysignificant (P <0.05), there was no significant difference in other groups (P>0.05).⑤Thedifference of the incidence of elevated erythrocyte sedimentation rate (ESR>20mm/h) inevery first clinical symptom group was not significant, there was no significant difference inother groups (P>0.05); The incidence of elevated C reactive protein (CRP>3mg/L) was lowerin mucocutaneous symptoms group than in other groups, the difference was statisticallysignificant (P <0.05); The incidence of elevated CRP was higher in respiratory systemsymptom group than in other groups, the difference was statistically significant (P <0.05);there was no significant difference in other groups (P>0.05); The difference of the incidenceof Rheumatoid factor increasing in every first clinical symptom group was not significant,there was no significant difference in other groups (P>0.05).⑥The difference of lacrimalgland secretion decreasing in every first clinical symptom group was not significant, therewas no significant difference in other groups (P>0.05).⑦In pSS patients：the incidence ofIgG elevated, IgA elevated, IgM elevated, C3decreased, C4decreased were75%,15%,10%,28%and13%respectively;The incidences of anti SSA positive and anti SSB positive were80%and69%. Immunoglobulin level in urinary symptom group was higher than the othergroups, and it was more obvious that IgA and IgG elevated, C3decreased. But there was no significant difference in other groups (P>0.05). The difference of the incidence of elevatedIgA, IgG, IgM and decreased C3and C4in every group was not significant, there was nosignificant difference above (P>0.05); The strong positive rates of anti SSA antibody and antiSSB antibody were higher in the first symptom of blood system and respiratory systemsymptom group than the other groups, the difference was statistically significant (P <0.05).There was no significant difference in other groups (P>0.05). Conclusions:1. pSS can causemultiple system damage.The clinical features are different in patients with first symptom. Thesystem is involved, but there would be differences in routine laboratory tests, immunologyindex, ect.2. Raynaud’s phenomenon and fever are more often appeared in respiratory systemsymptom group. The incidences of reduced leucopenia and elevated CRP are higher, thestrong positive rates of anti SSA antibody and anti SSB antibody are higher in respiratorysystem symptom group than in the other groups.3. The incidence of mumps virus is higher inurinary symptom group than in the other groups, the incidences of hematuria, proteinuria andelevated creatinine, urea nitrogen are higher. Immunoglobulin levels are higher in this groupof patients, and it is more obvious that IgA and IgG elevated, C3decreased.4. The incidenceof reduced leucopenia and the strong positive rate of anti SSA antibody and anti SSB antibodyare higher in the first symptom of blood group system, but there is no significant differencewith respiratory system symptom group. The incidences of reducing platelet and decreasinghemoglobin are higher.5.The incidences of reducing serum albumin and elevating C reactiveprotein are lower.6.The incidences of elevating aspartate aminotransferase and Alt are higherin the digestive system symptom group. |
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