造血干细胞移植引起的慢性移植物抗宿主病口腔黏膜及牙周状况的调查分析

doi:10.19439/j.sjos.2018.06.011

摘要/Abstract

摘要： 目的: 观察造血干细胞移植（hematopoietic stem cell transplantation,HSCT）后有慢性移植物抗宿主病患者的早、晚期口腔黏膜及牙周改变的临床表现,探讨慢性移植物抗宿主病对口腔状况的影响。方法: 收集108例造血干细胞移植后患者,按移植后治疗时间不同分为移植时间小于1年(n=32)和超过1年(n=43) 2组。采用问卷调查、临床检查,收集临床资料,确定罹患口腔慢性移植物抗宿主病患者的基本信息,记录口腔黏膜及牙周病损及严重程度,采用SPSS21.0软件包进行统计学分析。结果: HSCT后出现口腔表征发生率为78.95%,HSCT小于1年组与HSCT超过1年组的轻度症状发生率分别为59.38%和18.60%,差异显著（ χ²=11.525,P=0.001）;HSCT超过1年的苔藓样反应与HSCT小于1年的发生率分别为60.47%和31.25%,差异有统计学意义（χ²=6.274,P=0.012）;浅、中度牙周袋患者检出率分别为49.38%和40.74%;可视牙菌斑、牙结石、牙龈出血检出率分别为62.96%、64.20%和50.62%。结论: HSCT后黏膜及牙周改变的发生率较高,早期口腔黏膜慢性移植物抗宿主病轻度症状明显,晚期口腔表现则以苔藓样反应为主。

关键词: 造血干细胞移植, 口腔慢性移植物抗宿主病, 口腔黏膜, 牙周状态

Abstract: PURPOSE: The aim of this study was to investigate the severity and status of oral mucosa and periodontal status in early and late stage after receiving hematopoietic stem cell transplantation(HSCT). METHODS: This study enrolled patients submitted to hematopoietic stem cell transplantation. Through a survey questionnaire, clinical examination, we collected clinical data from 108 HSCT recipients and divided them into 2 groups: transplantation time less than 1 year and more than 1 year. The oral mucosal and periodontal status were recorded and statistically analyzed with SPSS 21.0 software package. RESULTS: The incidence of oral features after HSCT was 78.95%. The incidence of mild symptoms with HSCT less than 1year (n=32) and HSCT more than 1 year (n=43) was 59.38% and 18.60%, respectively. There was significant difference between the two groups (χ²=11.525, P=0.001).The percent of lichenoid/hyperkeratotic plaques was 31.25% and 60.47%, respectively. The lichenoid/hyperkeratotic plaques were significantly different between the two groups (χ²=6.274, P=0.012). The detection rate of shallow and moderate pockets was 49.38% and 40.74%, respectively. Visual plaque, calculus and bleeding on probing were 62.96%, 64.20% and 50.62%, respectively. CONCLUSIONS: The incidence of periodontal and mucosal lesions after HSCT is high. The mild symptoms of oral graft versus host disease in early stage are identified obviously, mainly like lichenoid/hyperkeratotic plaques in late stage.

Key words: Hematopoietic stem cell transplantation, Oral chronic graft-versus-host Disease, Oral mucosa, Periodontal status

中图分类号:

R781.5

吕柯佳, 闫朵朵, 汪国华, 姚亚男, 姚华. 造血干细胞移植引起的慢性移植物抗宿主病口腔黏膜及牙周状况的调查分析[J]. 上海口腔医学, 2018, 27(6): 617-623.

LV Ke-jia, YAN Duo-duo, WANG Guo-hua, YAO Ya-nan, YAO Hua. A primary analysis of oral mucosa and periodontal status of chronic graft-versus-host disease caused by hematopoietic stem cell transplantation[J]. Shanghai Journal of Stomatology, 2018, 27(6): 617-623.

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