原发性干燥综合征(primary Sjögren syndrome, PSS)是一种以外分泌腺和其他器官淋巴细胞浸润为特征的自身免疫性疾病。PSS临床表现异质性强,可出现不同程度的局部和系统受累,需通过多学科协作制定治疗方案。然而,目前我国缺乏统一的诊疗规范。多名相关学科专家基于国内外诊治经验和指南共识,通过名义群体法形成本共识,旨在为PSS患者的规范化诊疗提供指导和参考依据。
Primary Sjögren's syndrome (pSS) is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands and other organs. pSS has strong clinical heterogeneity, with topical and systemic involvement with varying degrees of severity, and requires multidisciplinary collaboration to develop treatment strategies. However, there is currently no homogenous approach to the diagnosis and treatment of pSS in China. Experts from multiple related disciplines gave their opinions based on the evidence and guidelines from China and other countries, and agreement between them was achieved using the Nominal Group Technique, with the purpose of providing guidance for rational management of pSS patients.
[1] Shiboski CH, Shiboski SC, Seror R, et al.2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjogren’s syndrome[J]. Ann Rheum Dis, 2017, 76(1): 9-16.
[2] Seror R, Bowman SJ, Brito-Zeron P, et al.EULAR Sjögren’s syndrome disease activity index (ESSDAI)[J]. RMD Open, 2015, 1(1): e000022.
[3] 张文,厉小梅,徐东,等. 原发性干燥综合征诊疗规范[J]. 中华内科杂志,2020,59(4): 269-276.
[4] 张文,陈竹,厉小梅,等. 原发性干燥综合征诊疗规范[J]. 中华内科杂志,2023,62(9): 1059-1067.
[5] Trevisani VFM, Pasoto SG, Fernandes MLMS, et al.Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjogren’s syndrome (Part I)[J]. Adv Rheumatol, 2019, 59(1): 58.
[6] Jousse-Joulin S, D’Agostino MA, Nicolas C, et al. Video clip assessment of a salivary gland ultrasound scoring system in Sjögren’s syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise[J]. Ann Rheum Dis, 2019, 78(7): 967-973.
[7] Ramos-Casals M, Brito-Zerón P, Bombardieri S, et al.EULAR recommendations for the management of Sjogren’s syndrome with topical and systemic therapies[J]. Ann Rheum Dis, 2020, 79(1): 3-18.
[8] 亚洲干眼协会中国分会,海峡两岸医药卫生交流协会眼科学专业委员会眼表与泪液病学组,中国医师协会眼科医师分会眼表与干眼学组, 等. 中国干眼专家共识:免疫性疾病相关性干眼(2021年)[J]. 中华眼科杂志,2021,57(12): 898-907.
[9] Trevisani VFM, Pugliesi A, Pasoto SG, et al.Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary sjogren syndrome: results of an epidemiologic systematic review/meta-analysis and a consensus guideline from the Brazilian Society of Rheumatology (articular, pulmonary and renal)[J].Adv Rheumatol,2022,62(1):18.
[10] Yueting L, Lin Q, Jian X, et al.Long-term survival analysis of patients with primary Sjögren’s syndrome in China[J]. Int J Rheum Dis, 2024, 27(9): e15284.
[11] Lee AS, Scofield RH, Hammitt KM, et al.Consensus guidelines for evaluation and management of pulmonary disease in Sjogren’s[J]. Chest, 2021, 159(2): 683-698.
[12] Trevisani VFM, Pinheiro AC, de Magalhães Souza Fialho SC, et al. Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjogren syndrome: results of an epidemiologic systematic review/meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)[J]. Adv Rheumatol, 2022, 62(1): 35.
[13] Xu D, Fang J, Zhang S, et al.Efficacy and safety of telitacicept in primary Sjögren’s syndrome: a randomized, double-blind, placebo-controlled, phase 2 trial[J]. Rheumatology (Oxford),2024, 63(3): 698-705.
[14] Alunno A, Carubbi F, Bartoloni E, et al.The kaleidoscope of neurological manifestations in primary Sjögren’s syndrome[J]. Clin Exp Rheumatol, 2019, 37 Suppl 118(3): 192-198.
[15] Pugliesi A, Egypto DCSD, Duffles G,et al.Recommendations on cutaneous and hematological manifestations of Sjögren’s disease by the Brazilian Society of Rheumatology[J]. Adv Rheumatol, 2024, 64(1): 51.
[16] 中华中医药学会风湿病分会. 干燥综合征病证结合诊疗指南[J]. 中医杂志,2024,65(4): 434-444.
[17] Baldini C, Fulvio G, La Rocca G, et al.Update on the pathophysiology and treatment of primary Sjögren syndrome[J]. Nat Rev Rheumatol, 2024, 20(8): 473-491.