謝格連氏症候群在牙科臨床上之診斷與治療－病例報告

Diagnosis and Management of Sjögren's Syndrome in Dental Practice-Cases Report

呂宜蓉(Yi-Jung Lu) ； 林光勳(Kuang-Hsun Lin) ； 黃瓊芳(Chiung-Fang Huang)

《中華牙醫學雜誌（中文版）》 25卷3期 (2006/09) Pp. 205-212

https://doi.org/10.7106/CJD.200609.0205

摘要

謝格連氏症候群是一種臨床病理綜合體，特徵包括口乾與眼乾，乃自體免疫機轉破壞外分泌腺體所致，此病好犯中年女性，既可獨立發生，又可伴發於其他自體免疫疾病，最常見的口腔症狀為口乾及多發性齲齒，治療方式主以症狀治療為主。本次報告兩病例，病例一為62歲女性，主訴口乾，有關節炎之病史，經血清檢查及下唇唾液腺切片檢驗，確定屬謝格連氏症候群，爾後由風濕免疫科證實為全身紅斑性狼瘡患者；病例二為42歲女性，經風濕免疫科診斷為謝格連氏症候群，因多發性齲齒而至牙科做進一步處置，接受全口齲齒填補及固定假牙贋復，目前兩位患者每日居家塗氟及定期門診追蹤，口腔衛生情況控制良好。對此類病患而言，牙醫師往往是站在第一線，希望透過本文介紹，讓大家對此病有足夠的了解與警覺性，才能早期診斷與及早介入治療，減緩疾病的進程及口乾所造成的不適，以提高病人的生活品質。

關鍵字

謝格連氏症候群 ； 口乾 ； 齲齒

並列摘要

Sjögren's syndrome is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in xerostomia and dry eyes. The condition may occur in the absence of connective tissue disease (primary) or in association with it (secondary). It is seen predominantly in middle-aged women. The most prominent oral manifestations include xerostomia and an increase in dental caries. Treatment is aimed at symptomatic relief and limiting the damaging local effects. In this report, we present 2 cases of Sjögren's syndrome and their diagnostic and management procedures. Case 1 was a 62-year-old female who complained of xerostomia and had suffered from rheumatoid arthritis for 10 years. Serologic tests and a biopsy of the labial minor salivary glands allowed us to diagnose her with Sjögren's syndrome. After further examination by a rheumatologist, lupus erythematosus was the final diagnosis. Case 2 was a 42-year-old female who complained of multiple carious lesions due to xerostomia. The rheumatologist diagnosed her as having Sjögren's syndrome and referred her to our department for dental treatment. We performed restoration and prosthetic fabrication for her carious teeth. Both of these patients received fluoridation at home every day. Regular follow-up examinations showed that they both were able to maintain a good oral condition. Sjögren's syndrome is a widely underdiagnosed disease. Treatment for th disease is available, but there is no cure. A complete understanding of the disease process and management of Sjögren's syndrome may prevent delays in diagnosis, allow an appropriate diagnostic evaluation, and optimize the therapeutic intervention.

並列關鍵字

Sjögren's syndrome ； xerostomia ； dental caries