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目的评价唾液腺半定量超声评分系统在干燥综合征(Sj?gren’s syndrome,SS)中的诊断价值。方法 2014年6月至2016年6月于西南医院风湿免疫科怀疑为SS的98例患者纳入研究,男性35例,女性63例,年龄35~72岁,平均(52.3±19.8)岁。回顾性分析其腮腺和颌下腺超声检查灰阶与彩色多普勒血流显像声像图表现,将其分为0~4级,获得相应评分,绘制受试者工作特征曲线(receiver operating curve,ROC),计算曲线下面积(area under curve,AUC),评价其诊断价值。对唾液腺超声评分左右侧之间的差异进行比较。对工作经验分别为10年和2年的两名医师评分一致性进行检验。结果 98例患者中53例确诊为SS,45例被排除。唾液腺超声评分所形成ROC曲线AUC为0.892。以2为截断点,唾液腺超声评分法诊断SS的敏感性为94.34%,特异性为88.89%,阳性预测值为90.91%,阴性预测值为93.02%。腮腺和颌下腺超声评分左右侧之间无显著差异性(P>0.05)。不同工作经验的两名医师评分一致性分析Kappa值0.884(P<0.05)。结论唾液腺超声0-4级半定量评分系统对SS具有较高的诊断价值,且观察者一致性好,可用于SS的临床诊断。
Objective To evaluate the diagnostic value of salivary gland semi-quantitative ultrasound scoring system in Sjögren’s syndrome (SS). METHODS: From June 2014 to June 2016, 98 patients with suspected SS in the Department of Rheumatology, Southwest Hospital were enrolled in the study. There were 35 males and 63 females, aged 35-72 years (mean, 52.3 ± 19.8 years). Retrospective analysis of the parotid and submandibular gland by ultrasonography grayscale and color Doppler flow imaging sound imaging performance, divided into 0 to 4 grades, access to the corresponding score, draw the receiver operating curve (receiver operating curve, ROC), area under curve (AUC) was calculated to evaluate its diagnostic value. Differences between the left and right salivary gland ultrasound scores were compared. Test the consistency of the scores of two doctors with working experience of 10 years and 2 years respectively. Results Of the 98 patients, 53 were diagnosed as SS and 45 were excluded. The AUC of salivary gland ultrasound score formed by ROC curve was 0.892. With 2 as the cut-off point, the sensitivity of salivary gland ultrasound was 94.34%, the specificity was 88.89%, the positive predictive value was 90.91%, the negative predictive value was 93.02%. Parotid and submandibular gland ultrasound scores between the left and right no significant difference (P> 0.05). Kappa values of 0.884 (P <0.05) for two physicians with different work experience. Conclusion The 0-4 grade semi-quantitative scoring system of salivary gland ultrasound has a high diagnostic value for SS, and the consistency of the observer is good. It can be used for the clinical diagnosis of SS.