| Objective: To explore the clinical features of pSS patients with thymic abnormalities Methods: We retrospectively analyzed the data of patients with thymic abnormalities in chest CT examinations in the department of our hospital from October 2013 to July2017.We also selected the pSS patients with normal thymus of chest CT examinations in the same period as a control group.The clinical differences between the two groups were compared.The patients performed the surgery were compared with the cntrol group.Results1.Clinical results of patients with pSS-thymic abnormalities(1)Basic information There were 31 patients in the abnormal pSS-thymus group,including 3 males and 28females;male: female = 1:9.33,age 24-67 years,mean(45.7±1.9)years old.The course of the disease is 0.5-24 years and the average course is(3.73 ± 1.06)years.(2)Clinical features of patients with pSS-thymic abnormalities The most common clinical features are dry mouth and dry eyes,followed by joint pain and decayed teeth.(3)Systematic involvement of pSS-thymus abnormal group The blood system is most affected,followed by 8 cases of lung lesions(25.8%),and pSS lung lesions was the most common pulmonary interstitial lesion of 6 cases(19.35%),followed by pulmonary hypertension in 2 cases(6.45%).Thyroid function was abnormal in 3 cases(9.68%),including 1 case of hyperthyroidism(3.23%),1case of hypothyroidism(3.23%),1 case of Hashimoto's thyroiditis(3.23%),liver function was abnormal was abnormal in 3 cases(9.68%),Kidney function was abnormal in 1 patients(3.23%).(4)Immune index of patients with abnormal pSS-thymus Ig G,Ig A,Ig M were elevated,C3?C4 decreased;ANA positive rate was high.The spot type was most common,including 15 cases(48.39%).Anti-SSA antibody was positive in 27 cases(87.09%),and anti-SSB antibody was positive in 22 cases(70.97%).ANCA positive rate was low;ESR and RF increased significantly.2.Patients with abnormal pSS-thymus and pSS-thymic normal patients(1)Comparison of clinical basic informations: The pSS-thymological abnormal group was diagnosed at a younger age and a shorter course of disease,and the difference was statistically significant(P<0.05).(2)Comparison of laboratory indicators:Blood tests comparison: WBC(3.84±0.47)in the pSS-thymoma group was lower than that in the pSS-thymus group(5.41±2.13),and the difference was statistically significant(P<0.05).Comparison of biochemical Indexes: Scr(mmol/L)(58.19±10.39)was significantly lower in the pSS-thymoma group than in the pSS-thymic normal group(67.34 ±17.46).The difference was statistically significant..Immune index comparison: There was no significant difference in immunoglobulin,complement C3,complement C4,RF,anti-SSA antibody,anti-SSB antibody,and ESR(P>0.05).(3)Comparison between pSS-thymologically operated group patients and pSS-thymic normal group: There were significant differences in WBC,Ig A,complement C4,ESR,and RF between the two groups(P<0.05).(4)WBC,Ig A,complement C4,ESR and RF were respectively analyzed by logistic single factor,and WBC was statistically different.Conclusions1.Patients with abnormal thymus should pay attention to screening for autoimmune diseases2.Young female patients with pSS with decreased WBC should be vigilant for the combination of thymus abnormalities3.The levels of immunoglobulins and complement in patients with pSS combined with thymus abnormalities tended to improve after thymus surgery intervention4.PSS can be combined with thymic lymphoma,which should be paid attention by clinicians... |
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