Sjögren症候群の唾液腺分泌能に対する副腎皮質ステロイドの治療効果 : 唾液腺シンチグラフィーによる評価

Abstract

The purpose of this study was to ascertain the effect of corticosteroids on the function of salivary glands evaluated by sialoscintigraphy in patients with Sjögren's syndrome (SS). Subjects enrolled in this study were 21 patients with SS. They were divided into two groups : group 1 (9 cases, 53.4±3.8y.o) treated with prednisolone (total doses 2.4～30.4 g, 8～70 months), and group 2 (12 cases, 55.2±3.5y.o) not treated with predptsolone. The function of each salivary gland was evaluated quantitatively and sequentially, using salivary gland scintigraphy with ⁹⁹ᵐTc-pertechnetate. The secretion rate after stimulation (TAR) with 1M tartanic acid was determined as the parameter indicating the function of each salivary gland. TAR of each salivary gland after prednisolone therapy in group 1 showed a trend of increase or significant increase compared with that before prednisolone therapy. In particular, TAR of right submandibular gland significantly improved (before vs after therapy ; 20.3±6.6% vs 28.3±7.5%, p＜0.05). TAR of each salivary gland in group 2 showed no changes during observation. There was no significant relationship between the frequency of cases with improved TAR and the histological grade of each salivary gland. Therfore, corticosteroids are effective in treat- ment for the function of each salivary gland, independent of the histological grade of salivary gland in SS. We concluded that corticosteroids are effective in treatment for the function of the salivary glands in patients with SS, and that sialoscintigraphy is useful for evaluating the function of salivary glands in SS during corticosteroid therapy.