Sialogogues signs of change the major salivary glands in patients with sjogren's syndrome


Relevance. The prevalence of Sjogren’s syndrome (SS) varies from 0.1 to 3.3% in the General population. Despite the fact that the treatment school must conduct primarily a rheumatologist, that the dentist, in particular, dental surgeon, depends on accurate and timely diagnosis of the disease. Often in the diagnosis of nonneoplastic diseases of the major salivary glands (BUJ) ispolzuyutsya ultrasonography (us), however standard research methodology is not sufficiently informative, in particular in relation to the initial stage of the disease. The purpose of this study was - the increase of efficiency of diagnostics of school through the use of an improved method of sialogogue with contrast excretory ducts BUJ saline solution. Material and methods. The study included 40 patients with NL. To assess the secretory function of the salivary glands was performed salumeria. Evaluated biochemical parameters, specific to school, in the peripheral blood. As radiological methods of investigation used native ultrasound, ultrasound with contrast and traditional sialography. Results. Patients of the 1st group the data of biochemical analysis ofperipheral blood about the presence of the initial stage n and autoimmune thyroiditis, ifsialography pronounced changes in the ductal tree is not revealed when the native sialagogue visualized parotid gland (PG) with smooth, clear contours, normal echogenicity and main excretory duct. When filled with saline noted the clear contouring of the duct until the acini; the terminal divisions of the excretory ducts was determined cysto- and anulowanie expansion. Patients of the 2nd group biochemical analysis of peripheral blood revealed the presence of clinically expressed stage school with the accession of autoimmune destruction of the thyroid gland, according to sialography identified multiple depot of contrast size of 1-3 mm, according to native ultrasound, increased PG were visualized with smooth clear contours, the echogenicity of the parenchyma of the gland was reduced, with heterogeneous echostructure, with the presence of multiple small, more hypoechogenic areas in diffuse parenchymal part. After infusion of saline was possible to visualize the course of the ducts 2-4 orders of magnitude, their tortuosity, confirmed the connection between the channels and revealed hypoechoic areas in the parenchymal part of the parotid gland that have proven their cystic nature. Patients in the comparison group with native echography visualized parotid gland with smooth, clear contours, echogenicity regular, not advanced duct. Thus, the execution ofSJ vnutrimatocny ultrasound with introduction of saline solution allows to evaluate the structure of the studied gland: to trace the course of the system of ducts, to identify the communication duct with hypoechoic areas in the parenchyma of the LF, which is especially important in patients with syndrome or Sjogren disease. Diagnostic specificity for contrast sialogogue was 100,0%, sensitivity - of 90,9%, accuracy - of 97,5%, a positive predictive value - of 96,7%, negative -100%. Conclusions. An improved method of sialogogue the breast ducts with saline revealed a communication with the excretory ducts of the hypoechoic areas in the parenchyma of the salivary glands. Quantification of markers n and the presence of autoimmune destruction of the thyroid gland revealed significant differences in patients with primary and secondary school stages expressed in healthy people. Contrast sialagogue high resolution has high diagnostic specificity, sensitivity, accuracy, predictive value positive and negative results. The proposed method can be used for screening and identification of SSH in patients with thyroid disorders, Allergy to iodine-containing medications and in pregnancy.

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About the authors

Marina Vladlenovna Kozlova

Moscow state medical dental University A.I. Evdokimov

127473, Moscow
Dr. med. Sciences, Professor

I. S Repin

Moscow state medical dental University A.I. Evdokimov

127473, Moscow

M. V Smyslenova

Moscow state medical dental University A.I. Evdokimov

127473, Moscow

E. I Selivanova

”Research Institute of rheumatology named after V.A. Nasonova”

115522, Moscow


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