OBJECTIVE Our aim was to develop an ultrasonographic scoring model for staging hypofunction of salivary glands (SGs) in patients with Sjögren disease (SjD). METHODS The assessment of SG secretory hypofunction was conducted by measuring whole salivary flows. B-mode ultrasonography was performed bilaterally on the parotid and submandibular glands to quantitatively evaluate the gland score and Outcome Measures in Rheumatology (OMERACT) score. The correlation between these scores and SG secretory function in patients with SjD was analyzed, leading to the development of an ultrasonographic scoring model for staging SG hypofunction. RESULTS A 1-center derivation cohort comprising 164 patients with SjD and a double-center validation cohort consisting of 107 patients with SjD were included. Both ultrasonographic scores demonstrated excellent discriminatory ability between patients with SjD with hypofunction and those with normal function (area under the curve > 0.8 for both; P < 0.001). A novel ultrasonographic scoring model revealed that low total OMERACT scores (< 5) indicated initial-stage SG hypofunction, whereas high scores (> 9) suggested end-stage hypofunction. Conversely, patients with moderate-level total OMERACT scores (5-9) required further stratification using total gland scores. The incidence of SG hypofunction among all 271 patients with SjD was found to be 18% in the initial stage, 58% in the progressive stage, and 100% in the end stage (P < 0.01). Further, the incidence of lacrimal gland involvement and hyperglobulinemia (IgG > 16 IU/mL) was significantly lower in the initial-stage patients compared to those at other stages (all P < 0.01). CONCLUSION The novel ultrasonographic scoring model incorporates precise definitions for each stage of SG hypofunction, providing a robust and clinically significant approach to stratification of SG secretory hypofunction in SjD.

中文翻译：

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基于唾液腺超声检查的分层方法用于评估干燥病的分泌功能。


目的 我们的目的是开发一种超声评分模型，用于对干燥病 （SjD） 患者唾液腺 （SGs） 功能减退进行分期。方法 通过测量全唾液流量来评估 SG 分泌性功能减退。双侧对腮腺和下颌下腺进行 B 型超声检查，以定量评估腺体评分和风湿病学结果测量 （OMERACT） 评分。分析了这些评分与 SjD 患者 SG 分泌功能之间的相关性，从而开发了用于分期 SG 功能减退的超声评分模型。结果 纳入一个由 164 例 SjD 患者组成的 1 中心衍生队列和一个由 107 例 SjD 患者组成的双中心验证队列。两项超声评分均显示功能减退的 SjD 患者与功能正常的 SjD 患者之间具有出色的鉴别能力 （两者的曲线下面积 > 0.8;P < 0.001）。一种新的超声评分模型显示，低总 OMERACT 评分 （< 5） 表明初始阶段 SG 功能减退，而高分 （> 9） 表明终末期功能减退。相反，OMERACT 总分中等水平 （5-9） 的患者需要使用腺体总分进一步分层。发现所有 271 例 SjD 患者 SG 功能减退的发生率在初始阶段为 18%，在进展阶段为 58%，在终末阶段为 100% （P < 0.01）。此外，与其他阶段患者相比，初始患者泪腺受累和高球蛋白血症 （IgG > 16 IU/mL） 的发生率显著降低 （均 P < 0.01）。 结论 新颖的超声评分模型结合了 SG 功能减退每个阶段的精确定义，为 SjD 中 SG 分泌功能减退的分层提供了一种稳健且具有临床意义的方法。