Abstract | Cilj: Glavni cilj istraživanja bio je prikazati komparativan opis kliničkih i laboratorijskih pokazatelja kod bolesnika sa pSB, sSB i bolesnika sa sicca simptomima. Specifični ciljevi istraživanja bili su: odrediti najčešće pridružene autoimune bolesti kod bolesnika sa sSB; odrediti demografske, kliničke i laboratorijske karakteristike kod bolesnika sa pSB temeljem dobi i anti-SSA; odrediti učestalost bolesnika sa pSB, sSB i sicca simptomima temeljem FS. Materijali i metode: Istraživanje je uključivalo 84 pacijenta, od kojih je 76 žena i 8 muškaraca. Od ukupno 84 pacijenta, 27 ih je bilo s dijagnozom pSB, 4 s dijagnozom sSB, a ostalih 53 imali su sicca simptome. Od svih ispitanika uzeti su: medicinska anamneza, demografski podaci, duljina trajanja simptoma (u mjesecima), testovi procjene suhoće očiju (Schirmer test, TBUT), UWS i SWS (ml/min) i FS. Od laboratorijskih nalaza uzeti su: SE, CRP, RF, anti-CCP, C3 i C4, ANA, ENA i serumski vitamin D. Procjenu aktivnosti bolesti odredili smo pomoću EULAR objektivnog mjernog instrumenta aktivnosti bolesti (EESSDAI). Rezultati: PSB i sSB pacijenti imali su statistički značajno niže vrijednosti UWS i SWS u odnosu na nSB (P < 0,001, P < 0,001). PSB i sSB pacijenti imali su statistički značajno veću zastupljenost ANA u odnosu na nSB (P = 0.005), kao i veći indeks aktivnosti bolesti (ESSDAI) u odnosu na nSB (P = 0.026). PSB pacijenti imali su statistički značajno veću zastupljenost anti-SSA/Ro60 (29,6 % vs. 3,8 %, P = 0,002), anti-SSA/Ro52 (37,0 % vs. 9,4 %, P = 0,003) i anti-SSB (22,2 % vs. 1,9 %, P = 0,005). FS ≥ 1 bio je statistički značajno više zastupljen kod pSB i sSB pacijenata u odnosu na nSB (P < 0,001). Zaključak: Bolesnici sa pSB i sSB pokazali su različite kliničke i laboratorijske parametre u odnosu na pacijente sa sicca simptomima. Evaluacija usne šupljine (UWS i SWS) i histopatološka analiza biopsije malih labijalnih žlijezda slinovnica (izračun FS) pokazali su se vrijednim i nezamijenjivim dijagnotičkim alatima za dijagnozu SB. |
Abstract (english) | Objectives: The main objective of the study was to present a comparative description of clinical and laboratory indicators in patients with primary Sjögren's disease (pSD), secondary Sjögren's disease (sSD) and patients with sicca symptoms (nSD). The specific objectives of the study were: to determine the most common associated autoimmune diseases in patients with sSD; to determine the demographic, clinical and laboratory characteristics of patients with pSD based on age and anti-SSA; to determine the prevalence of patients with pSD, sSD and sicca symptoms based on FS. Materials and Methods: The study included 84 patients, of whom 76 were women and 8 were men. Of the total 84 patients, 27 were diagnosed with pSD, 4 with sSD, and the remaining 53 had sicca symptoms. The following data was collected from all participants: medical history, demographic data, symptom duration (in months), ocular dryness assessment tests (Schirmer test, TBUT), UWS and SWS (ml/min), and FS. Laboratory findings included: ESR, CRP, RF, anti-CCP, C3 and C4, ANA, ENA and serum vitamin D. Disease activity was assessed using the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI). Results: The PSB and sSB patients had statistically significantly lower UWS and SWS scores compared to nSB (P < 0.001, P < 0.001). The PSB and sSB patients had a statistically significantly higher prevalence of ANA compared to nSB (P = 0.005), as well as a higher disease activity index (ESSDAI) compared to nSB (P = 0.026). The PSB patients had a statistically significantly higher prevalence of anti-SSA/Ro60 (29.6% vs. 3.8%, P = 0.002), anti-SSA/Ro52 (37.0% vs. 9.4%, P = 0.003 ) and anti-SSB (22.2% vs. 1.9%, P = 0.005). FS ≥ 1 was statistically significantly more frequent in pSB and sSB patients compared to nSB (P < 0.001). Conclusions: The patients with pSB and sSB showed different clinical and laboratory parameters compared to patients with sicca symptoms. Examination of the oral cavity (UWS and SWS) and histopathological analysis of the labial minor salivary glands (calculation of FS) proved to be valuable and indispensable diagnostic tools for the diagnosis of SB. |