过敏相关阻塞性腮腺炎的临床分析及超声研究

doi:10.3969/j.issn.1674-8115.2023.05.001

上海交通大学学报（医学版） ›› 2023, Vol. 43 ›› Issue (5): 519-523.doi: 10.3969/j.issn.1674-8115.2023.05.001

• 口腔外科专题 •

过敏相关阻塞性腮腺炎的临床分析及超声研究

陆一凡¹(), 张蔚蒨², 俞创奇¹()

^1.上海交通大学医学院附属第九人民医院口腔外科，上海交通大学口腔医学院，国家口腔医学中心，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所，上海 200011
^2.上海交通大学医学院附属第九人民医院超声科，上海 200011

收稿日期:2023-01-05 接受日期:2023-04-24 出版日期:2023-05-28 发布日期:2023-07-11
通讯作者: 俞创奇 E-mail:1152280535@qq.com;yuchuangqi2017@163.com
作者简介:陆一凡（1996—），男，硕士生；电子信箱：1152280535@qq.com。
基金资助:
国家自然科学基金(81771089);上海市自然科学基金(22ZR1437400)

Clinical analysis and ultrasound study of allergy-related obstructive parotitis

LU Yifan¹(), ZHANG Weiqian², YU Chuangqi¹()

^1.Department of Oral Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai 200011, China
^2.Department of Ultrasound, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2023-01-05 Accepted:2023-04-24 Online:2023-05-28 Published:2023-07-11
Contact: YU Chuangqi E-mail:1152280535@qq.com;yuchuangqi2017@163.com
Supported by:
National Natural Science Foundation of China(81771089);Shanghai Natural Science Foundation(22ZR1437400)

摘要/Abstract

摘要：

目的·探究过敏相关阻塞性腮腺炎（allergy-related obstructive parotitis，AROP）的临床特点及其导管的超声特征。方法·纳入2020年10月—2022年10月因腮腺反复肿胀于上海交通大学医学院附属第九人民医院口腔外科就诊并诊断为AROP的患者，回顾性分析患者的临床资料，包括病史、临床表现、实验室检查和影像学检查等。采用静态超声显示AROP导管的形态特征，通过超声图像测量导管扩张最宽处的内径并进行导管扩张程度分级。采用动态超声显示AROP患者在功能状态下导管的形态变化，计算导管增宽的数值及比例，并记录是否出现腮腺肿胀症状。结果·37例患者诊断为AROP并纳入研究，男性9例（24.3%），女性28例（75.7%）。临床症状以腮腺反复肿胀、皮肤瘙痒以及导管排出黏液栓子为主。32例患者（86.5%）伴有全身过敏病史。血清IgE浓度和外周血嗜酸性细胞（peripheral blood eosinophil，PBE）绝对计数升高的比例分别为59.5%和43.2%。37例AROP患者的静态超声结果以导管扩张为主要表现。导管扩张程度分级结果分别是轻度21例（56.8%）、中度10例（27.0%）、重度6例（16.2%）。7例AROP患者行动态超声检查，结果其中4例处于非症状期，3例处于症状期。结论·AROP是一种与过敏反应密切相关的慢性阻塞性腮腺炎，对于其诊断应从多方面综合考虑。超声能有效显示腮腺导管的形态特征，并能用于评估导管的阻塞状态，有助于AROP的诊断和随访。

关键词: 过敏相关阻塞性腮腺炎, 过敏反应, 超声, 导管扩张

Abstract:

Objective ·To explore the clinical features of allergy-related obstructive parotitis (AROP) and the ultrasonic characteristics of its duct. Methods ·Patients diagnosed with AROP at the Oral Surgery Department of Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from October 2020 to October 2022 due to recurrent swelling of parotid gland were included. Clinical data of the patients were retrospectively analyzed, including medical history, clinical manifestations, laboratory examinations and imaging examinations. Static ultrasound was used to display the morphological characteristics of the AROP duct, ultrasonic images were used to measure the inner diameter at the widest point of duct dilation, and the degree of duct dilation was graded. Dynamic ultrasound was used to show the morphological changes of the duct at the functional state of AROP patients. The value and ratio of duct widening were calculated, and the symptoms of parotid swelling were recorded. Results ·Thirty-seven patients were diagnosed with AROP and included in the study, including 9 males (24.3%) and 28 females (75.7%). The main clinical symptoms were recurrent swelling of parotid gland, skin itching and duct discharge of mucus plug. Thirty-two patients (86.5%) had a history of systemic allergic disease. The proportion of increased serum IgE concentration and peripheral blood eosinophil (PBE) absolute count was 59.5% and 43.2%, respectively. The static ultrasound results of 37 AROP patients were mainly manifested by duct dilation. The grading results of duct dilation degree were mild in 21 cases (56.8%), moderate in 10 cases (27.0%) and severe in 6 cases (16.2%). Seven patients with AROP underwent dynamic ultrasonography. Results showed that 4 patients were in the asymptomatic period and 3 patients were in the symptomatic period. Conclusion ·AROP is a type of chronic obstructive parotitis closely related to allergic reactions, and its diagnosis should be considered in many aspects. Ultrasound can effectively display the morphological characteristics of parotid duct, and can be used to assess the obstruction status of the duct, which is helpful for the diagnosis and follow-up of AROP.

Key words: allergy-related obstructive parotitis (AROP), allergic reaction, ultrasound, duct dilation

中图分类号:

R781.7

陆一凡, 张蔚蒨, 俞创奇. 过敏相关阻塞性腮腺炎的临床分析及超声研究[J]. 上海交通大学学报（医学版）, 2023, 43(5): 519-523.

LU Yifan, ZHANG Weiqian, YU Chuangqi. Clinical analysis and ultrasound study of allergy-related obstructive parotitis[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(5): 519-523.

图/表 4

表1 AROP患者的临床特点及实验室检查（n=37）

Tab 1 Clinical characteristics and laboratory examination of AROP patients （n=37）

Item	AROP
Gender/n (%)
Male	9 (24.3)
Female	28 (75.7)
Age/year	46.0 (41.0, 53.0)
Duration of disease/year	3.0 (2.0, 5.0)
Affected parotid gland/n (%)
Unilateral	18 (48.6)
Bilateral	19 (51.4)
Symptom/n (%)
Swelling	37 (100.0)
Itch	23 (62.2)
Mucus plug	26 (70.3)
Pain	5 (13.5)
Allergic history/n (%)	32 (86.5)
Raised IgE/n (%)	22 (59.5)
Raised PBE/n (%)	16 (43.2)

图1 导管扩张3个分级的典型超声图像Note： A. In a patient with mild duct dilation, the parotid duct was 2.7 mm wide. B.In a patient with moderate duct dilation, the parotid duct was 3.8 mm wide. C.In a patient with severe duct dilation, the parotid duct was 6.3 mm wide. The yellow dotted lines show the overall shape of the duct, and the yellow arrows show the widest dilation of the duct.

Fig 1 Typical ultrasound images of 3 grading of duct dilation

图2 AROP患者（症状期）的动态超声图像Note： A. In an AROP patient in the symptomatic period, the parotid duct was dilated in the resting state with a width of 5.3 mm. B.After eating sour candy, the duct was significantly dilated with a width of 7.9 mm. The yellow dotted lines show the overall shape of the duct, and the yellow arrows show the widest dilation of the duct.

Fig 2 Dynamic ultrasound images of an AROP patient (symptomatic period)

表2 AROP患者的动态超声结果（n=7）

Tab 2 Dynamic ultrasound results of the AROP patients （n=7）

AROP	Case No.	Width of duct/mm		Widening value/mm	Widening ratio/%	Swelling symptom
AROP	Case No.	Resting state	Functional state	Widening value/mm	Widening ratio/%	Swelling symptom
Asymptomatic period (n=4)	1	2.7	2.9	0.2	7.4	No
	2	2.1	2.5	0.4	19.0	No
	3	3.1	3.4	0.3	9.7	No
	4	5.3	6.2	0.9	16.7	No
Symptomatic period (n=3)	5	3.3	4.9	1.6	48.5	Yes
	6	5.3	7.9	2.6	49.1	Yes
	7	6.3	8.2	1.9	30.2	Yes

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过敏相关阻塞性腮腺炎的临床分析及超声研究

Clinical analysis and ultrasound study of allergy-related obstructive parotitis

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