Different Age Paragraph The Onset Of Clinical Analysis Of Patients With Primary Sjogren's Syndrome In The Hospital

Objective. To study the differences in clinical characteristics andexperiment profiles of primary Sj gren’s syndrome (pSS) with a differentonset age.Methods.227patients who fulfilled the2002internationalclassification (criteria) for pSS from the first affiliated hospital ofGuangxi Medical University between July2005and January2012werescreened retrospectively. These patients were divided into two groups: theyouth group (onset younger than40) and the middle-old age group (onsetolder than40). We retrospective analyzed their clinical manifestation andexperimental features.Results.(1)The study consisted of205(90.3%) female and22(9.7%)male patients (female: male=9.32:1). Mean age at the onset of thedisease was47.28±15.16years old. In73(32.2%) patients the diseaseonset occurred before the age of40years and154(67.8%) occurred afterthe age of40years, with an average age of [(29.66±7.26) years old vs (55.63±9.81) years old, P=0.000].(2) Dry mouth and dry eyes (29.1%),decayed tooth (14.1%) and joint pain (18.5%) were the top three morecommon initial symptoms, in addition, the former two initial symptomswere often found in the middle-old age group patients, significantlyhigher than the youth group (P≤0.01), however lower inthrombocytopenic purpura (P＜0.01).(3) Dry mouth (68.7%) was themost common symptoms, then dry eyes (43.2%) and decayed tooth(34.4%). There was a significant difference between the youth group andthe middle-old age group in decayed tooth (17.8%vs42.2%, P=0.000).The positive rates of labial gland biopsy, parotid sialography andexaminations for dry eye were about87%～95%.(4) Systemicinvolvement occurred in89.4%patients, including blood systeminvolvement60.4%, pulmonary involvement38.0%, renal involvement30.4%. Compared with the youth group and the middle-old age one, therewere significant difference in the following cases as pulmonaryinvolvement (26.7%vs43.2%, P=0.029), interstitial lung disease (13.3%vs27.3%, P=0.033), glomerulonephritis (8.2%vs18.2%, P=0.049), renalinsufficiency (2.7%vs13.0%, P=0.015) and thrombocytopenia (26.0%vs9.1%, P=0.001).(5) The most common autoantibodies was ANA (92.1%)and the main karyotype was particle type. The positive rates of SSA andSSB were78.9%and57.3%respectively. Besides, Serum immunologyincreased，71.6%of which was IgG. Compared with the youth andmiddle-old group, ANA (97.3%vs89.6%, P=0.046), particle type ofANA (67.1%vs44.8%, P=0.002), centromere type of ANA (5.5%vs15.6%, P=0.031), homogeneous type of ANA (1.4%vs9.7%, P=0.021),Ro52(86.3%vs73.4%, P=0.029).(6) The relevance of systemic involvement and laboratory parameters: lung involvement wtih theincrease of IgG and Glo (P＜0.01), ILD with the increase of IgG(P=0.009), renal damage or blood system involvement with the decreaseof C3and Alb (P＜0.05), liver involvement with SSB (P=0.014).Conclusion.(1) pSS occurred in patients of all ages, the rate of onsetof the youth group and the middle-old age group was about1:2.(2) Avariety of initial symptoms occurred in different onset age patients. Thetypical initial symptom of the middle-old age group were dry mouth anddry eyes and decayed tooth, while thrombocytopenic purpura was morecommon in the youth group.(3) Systemic involvement occurred in89.4%patients. Compared with the youth group, higher prevalence of interstitiallung disease, glomerulonephritis and renal insufficiency in the middle-oldage group, while much lower incidence of thrombocytopenia than theyouth group.(4) The karyotype of ANA was mainly particle type in youthgroup, but centromere type and homogeneous type of ANA were morecommom in middle-old age group.(5) pSS with renal damage or bloodsystem involvement were relevantly to the decrease of C3and Alb, liverinvolvement related to SSB(+), lung involvement was closely related tothe increase of IgG and Glo.