DeVita超声评分联合SWE在原发性干燥综合征腮腺损害中的诊断价值

焦兰兰; 李阳; 王兵; 王信; 隋洋; 孟飞逸

doi:10.16766/j.cnki.issn.1674-4152.004011

DeVita超声评分联合SWE在原发性干燥综合征腮腺损害中的诊断价值

doi: 10.16766/j.cnki.issn.1674-4152.004011

焦兰兰¹,
李阳^2, ,,
王兵²,
王信³,
隋洋²,
孟飞逸¹

1.
蚌埠医科大学研究生院，安徽蚌埠 233000
2.
蚌埠医科大学第一附属医院超声医学科，安徽蚌埠 233004
3.
蚌埠医科大学第一附属医院风湿免疫科

基金项目:

安徽省高校自然科学研究重点项目 2022AH051494

安徽省卫生健康科研项目 AHWJ2023A20372

详细信息

通讯作者:
李阳，E-mail：onlyworld_2012@126.com

中图分类号: R593.2 R445.1
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出版历程
- 收稿日期: 2024-08-29
- 网络出版日期: 2025-08-14

Diagnostic value of shear wave elastography combined with DeVita ultrasonic score in assessment of parotid gland lesions of Sjögren's syndrome

1.
Graduate School of Bengbu Medical University, Bengbu, Anhui 233000, China

摘要

摘要: 目的探讨DeVita超声评分联合剪切波弹性成像(SWE)在原发性干燥综合征(pSS)腮腺损害中的临床诊断价值，并分析二者与抗SSA和抗SSB抗体之间的相关性。方法选取2023年4月—2024年6月蚌埠医科大学第一附属医院风湿免疫科收治的pSS患者64例作为pSS组，另选择同期30名健康者作为对照组。采用常规二维超声观察腮腺形态学特征，并进行超声评分，SWE模式下获取腮腺杨氏模量平均值(Emean)。分别评估腮腺超声评分、Emean单独及两者联合在原发性干燥综合征腮腺病变中的诊断价值，并分析两者与血清学指标抗SSA和抗SSB抗体表达之间的相关性。结果 pSS组与对照组超声评分比较，差异有统计学意义(P＜0.05)；pSS组腮腺和对照组腮腺Emean比较，差异有统计学意义(P＜0.05)。ROC曲线显示，超声评分、SWE及两者联合评估腮腺损害的AUC分别为0.728、0.884和0.904，联合预测的AUC优于超声评分和SWE单独预测。抗SSA/SSB抗体表达与超声评分及SWE均相关(P＜0.05)。结论超声评分联合SWE在原发性干燥综合征腮腺损害中具有一定的临床预测价值。
- 原发性干燥综合征 /
- 剪切波弹性成像 /
- DeVita评分 /
- 腮腺 /
- 抗SSA抗体 /
- 抗SSB抗体
Abstract: Objective To investigate the clinical value of DeVita ultrasound scoring in collaboration with shear wave elastography (SWE) in parotid gland damage in primary Sjögren' s syndrome (pSS), and to analyze their correlation with anti-SSA and anti-SSB antibodies. Methods A total of 64 patients diagnosed with primary Sjögren' s syndrome (pSS) and admitted to the Department of Rheumatology and Immunology of the First affiliated Hospital of Bengbu Medical University, constituted the experimental group during the period from April 2023 to June 2024.In contrast, 30 healthy subjects were collected as the control group. The morphological characteristics of the parotid gland were obtained by means of routine ultrasound, after which ultrasound scoring was performed. The mean value of primary parotid Young ' s modulus (Emean) was obtained under SWE mode to evaluate the diagnostic value of parotid ultrasound score Emean alone and the combination of Emean in parotid damage of Sjögren ' s syndrome. Furthermore, the correlation between the above two groups of parameters and serological indicators of anti-SSA and anti-SSB antibodies expression was explored. Results A statistically significant discrepancy was identified in the ultrasound scores between the patients diagnosed with pSS and the subjects in control group (P < 0.05). A similar statistically significant discrepancy was identified in the parotid mean Emean values between the pSS patients and the control group (P < 0.05). ROC curve analysis revealed that the AUC of ultrasound score, SWE and the combined assessment of parotid lesions were 0.728, 0.884 and 0.904, respectively, and the AUC of the two was superior to that of ultrasound score and SWE. A significant correlation was identified between the expression of anti-SSA/SSB antibodies and ultrasound scores, as well as and SWE (P < 0.05). Conclusion The integration of SWE with ultrasound scoring has been demonstrated to possess a certain degree of clinical application value in the context of parotid lesions associated with of primary Sjögren' s syndrome.
- Primary Sjögren' s syndrome /
- Shear wave elastography /
- DeVita score /
- Parotid gland /
- Anti-SSA antibodies /
- Anti-SSB antibodies

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图 1 pSS患者腮腺病变二维超声评分示意图

注：A为超声评分1分；B为超声评分2分；C为超声评分3分；D为超声评分4分。

Figure 1. Schematic diagram of two-dimensional ultrasound scoring of parotid gland lesions in patients with pSS

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图 2 pSS患者腮腺病变剪切波弹性成像示意图

注：A为超声评分1分，平均杨氏模量值为14.75 kPa；B为超声评分2分，平均杨氏模量值为25.13 kPa；C为超声评分3分，平均杨氏模量值为34.54 kPa；D为超声评分4分，平均杨氏模量值为43.17 kPa。

Figure 2. Schematic diagram of shear wave elastography of parotid gland lesions in patients with pSS

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图 3 DeVita超声评分联合SWE对pSS患者腮腺病变诊断价值的ROC曲线

Figure 3. The ROC curve of the diagnostic value of DeVita ultrasound score combined with SWE for parotid gland lesions in patients with pSS

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表 1 2组研究对象实验室指标及血流分级比较

Table 1. Comparison of laboratory indicators and blood flow classification of the two groups of research subjects

组别	例数	ESR (x±s, mL/h)	IgG [M(P₂₅, P₇₅), g/L]	IgA [M(P₂₅, P₇₅), g/L]	血流分级(例)
组别	例数	ESR (x±s, mL/h)	IgG [M(P₂₅, P₇₅), g/L]	IgA [M(P₂₅, P₇₅), g/L]	0	Ⅰ	Ⅱ
pSS组	64	32.0(18.0, 52.5)	18.4(12.5, 21.0)	2.5(1.7, 2.9)	7	46	11
对照组	30	14.0(11.3, 15.8)	8.9(7.6, 10.4)	1.9(0.7, 2.7)	23	7	0
Z值		-2.597	-3.321	-1.340	-3.283
P值		0.009	0.001	0.180	0.001

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表 2 DeVita超声评分、SWE及两者联合对pSS患者腮腺病变的诊断效能分析

Table 2. Analysis of the diagnostic efficacy of DeVita ultrasound score, SWE, and their combination for parotid gland lesions in patients with pSS

项目	灵敏度(%)	特异度(%)	阳性似然比	阴性似然比	AUC	约登指数	P值
超声评分	84.37	66.67	2.53	0.23	0.728	0.51	＜0.001
Emean	93.33	90.62	13.59	0.10	0.884	0.84	＜0.001
两者联合	94.33	91.52	13.89	0.15	0.904	0.85	＜0.001

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