| Research background:Primary Sjogren’s syndrome(pSS)is a chronic systemic autoimmune disease,which is one of the more common diseases in rheumatic immunology department.It has a high incidence in epidemiological studies in China,but the prognosis is good and the survival rate is high.optic neuromyelitis spectrum disorder(NMOSD)is a group of demyelinating diseases of the central nervous system characterized by specific AQP4 antibodies.Its incidence is low,and there are geographical and ethnic differences,it is a rare disease,but the recurrence rate and disability rate are extremely high,and the survival rate is low.The coexistence of two diseases is more and more seen in clinic,but there are still few reports on the pathophysiological mechanism and clinical characteristics of the coexistence of the two diseases,so it is urgent to summarize and analyze the clinical characteristics of the co-occurrence of the two diseases,looking for indicative indicators to guide treatment.Purpose of the study:In this retrospective study,the general clinical data,laboratory indexes,antibody detection and imaging characteristics of patients in pSS with NMOSD group were analyzed separately,and then the differences of various indexes between pSS with NMOSD group and pSS group were analyzed,and meaningful indexes were selected for risk factor analysis,so as to deepen clinical workers’ understanding of the co-pathogenesis of the two diseases,reduce misdiagnosis and missed diagnosis,and improve the quality of life of patients.Research methods:A total of 29 pSS with NMOSD patients and 114 pSS without NMOSD patients in the same period were included in our hospital.The general clinical data such as age,sex and course of disease,the laboratory results of serum biochemistry,autoimmune antibody and AQP4 antibody,as well as MRI imaging examination of head and spinal cord were collected in the two groups.To describe,summarize and analyze the disease characteristics and the expression of related indexes in pSS with NMOSD group.Use correct statistical methods to compare the differences of clinical data and laboratory indexes between the pSS with NMOSD group and the control group,and.further analyze the risk factors.The results of the study are as follows:1.The patients in the pSS with NMOSD group were mainly female,with younger age of onset and shorter course of disease,specific or non-specific changes could be seen in cranial MRI,and spinal cord involvement was common,mainly cervical spinal cord involvement.The positive rate of AQP4 antibody in serum and cerebrospinal fluid is high.but there was no significant difference between two groups.There was no significant difference in serum PLT,NEU,MON,NLR,PLR,TP,GLOB,ALB,UA and inflammatory indexes(ESR,CRP and IgA、IgG、IgM)between the two groups.2.Compared with the control group,the pSS with NMOSD group had shorter course of disease(P=0.003),less symptoms of dry mouth and eye(P<0.05),fewer symptoms of fever(P=0.039)and skin purpura(P=0.026),higher serum levels of WBC,RBC,Hb and LYM,higher positive rate of anti-SSA antibody(P=0.027)and lower levels of complement C3 and C4(P<0.05).There was a great difference in the choice of treatment regimen.pSS with NMOSD group was mainly treated with glucocorticoid shock and immunosuppressant(P<0.05).3.The predisposing factors before the onset were the risk factors of pSS complicated with NMOSD(P=0.010,OR=0.140).Research conclusion:Shorter course of disease,dry mouth,dry eyes,fever and skin purpura were rare in pSS combined with NMOSD group.There were clear inducement before onset,high positive rate of serum anti-SSA antibody,low level of serum complement C3 and C4,and low positive rate of serum RF-IgM.Before the onset of the disease,there are clear incentives that are risk factors for pSS and NMOSD. |
