儿童外周血微量营养素与4种口腔黏膜病的关系：217例临床分析

doi:10.19439/j.sjos.2022.03.010

摘要/Abstract

摘要： 目的: 探讨0~14岁儿童外周血微量营养素水平与4种口腔黏膜病（轻型复发性阿弗他溃疡、口角炎、唇炎和地图舌）的关系。方法: 收集儿童口腔黏膜病(COML)患儿152例和健康儿童（HC）65例,分别记录各组临床资料,测定并比较血清水溶性维生素（维生素B1、B2、B3、B5、B6、B7、B9、B12、C）、血清脂溶性维生素[维生素A、E、K、25(OH)D2、25(OH)D3]、全血锌和血清钙离子水平是否存在差异,采用SPSS 23.0软件包,利用无序多分类logistic回归分析外周血微量营养素水平是否是COML发病的相关危险因素。结果: 外周血微量营养素在患有轻型复发性阿弗他溃疡、唇炎和地图舌的儿童中存在显著差异（P<0.05）。与HC组相比,轻型复发性阿弗他溃疡组儿童维生素B1、B6、B7、C、A、25(OH)D3水平显著降低（P<0.05）,[维生素B6（50.00%∶13.85%）、维生素B7（36.76%∶9.23%）、25(OH)D3（64.71%∶36.92%）]缺乏率、维生素K过量率（8.82%∶0.00%）显著较高（P<0.005）。无序多分类logistic回归分析结果显示,轻型复发性阿弗他溃疡儿童中,维生素B1、维生素C、维生素A缺乏、维生素B5、维生素K过量是其发病的危险因素,且各元素之间相互独立。与HC组相比,唇炎组儿童维生素B7、25(OH)D3水平显著降低（P<0.05）,维生素B7缺乏率较高（P<0.005）。无序多分类logistic回归分析显示,唇炎儿童中,维生素B7、维生素A缺乏是其发病的危险因素,且两者之间相互独立。与HC组相比,地图舌儿童维生素K过量率（7.14%∶0.00%）较高（P<0.005）。无序多分类logistic回归分析显示,地图舌儿童中,维生素C缺乏、维生素K过量是其发病的危险因素,且两者之间相互独立。与其他组相比,外周血微量营养素与口角炎发病无相关性（P>0.05）。结论: COML的发生与外周血微量营养素水平密切相关,提示COML儿童需要监测维生素和矿物质水平,并根据情况补充治疗。

关键词: 外周血微量营养素, 儿童, 口腔黏膜病, 无序多分类logistic回归分析

Abstract: PURPOSE: To investigate the relationship between peripheral blood micronutrient levels and 4 kinds of oral mucosal diseases (minor recurrent aphthous ulcer, angular cheilitis, cheilitis and geographic tongue) in children aged 0~14 years. METHODS: One hundred and fifty-two children with oral mucosal lesions (COML) and 65 healthy children (health control group, HC) were included. The clinical data of each group were recorded separately to compare whether there existed differences in the levels of serum water-soluble vitamins (vitamins B1, B2, B3, B5, B6, B7, B9, B12, C), serum fat-soluble vitamins [vitamins A, E, K, 25(OH)D2, 25(OH)D3], zinc and serum calcium. Whether peripheral blood micronutrients were risk factors associated with the onset of COML was analyzed through disorder multiclass logistic regression with SPSS 23.0 software package. RESULTS: Peripheral blood micronutrients differed in children with minor recurrent aphthous ulcers, cheilitis, and geographic tongue (P<0.05). Compared with HC group, children in minor recurrent aphthous ulcer group had significantly lower levels of vitamin B1, B6, B7, C, A, and 25(OH)D3 (P<0.05), and relatively higher rates of vitamin B6 (50.00% vs 13.85%), vitamin B7 (36.76% vs 9.23%), 25(OH)D3 (64.71% vs 36.92%) deficiency and vitamin K excess (8.82% vs 0.00%)(P<0.005). Multiclass logistic regression analysis showed that vitamin B1, vitamin C, vitamin A deficiency, vitamin B5, and vitamin K excess were risk factors for incidence in children with minor recurrent aphthous ulcer, and each element was independent for each other. Compared with HC group, the levels of vitamin B7 and 25(OH)D3 in children with cheilitis were significantly lower(P<0.05), and the rate of vitamin B7 deficiency was significantly higher (P<0.005). Multiclass logistic regression analysis showed that vitamin B7 and vitamin A deficiency were risk factors for cheilitis in children, and the two were independent for each other. Compared with the HC group, vitamin K excess rate was significantly higher in children with geographic tongue (7.14% vs 0.00%) (P<0.005). Multiclass logistic regression analysis showed that vitamin C deficiency and vitamin K excess were risk factors for the incidence of geographic tongue, and the two were independent for each other. Compared with other groups, peripheral blood micronutrients had no correlation with the pathogenesis of angular cheilitis (P>0.05). CONCLUSIONS: The occurrence of COML is closely related to peripheral blood micronutrient levels, which suggests that children with COML need to monitor vitamin and mineral levels and supplement treatment when necessary.

Key words: Peripheral blood micronutrients, Childhood, Oral mucosal diseases, Disorder multiclass logistic regression analysis

中图分类号:

R781.5

周勇, 周政权, 刘雪威, 张力木, 王也, 林晓萍. 儿童外周血微量营养素与4种口腔黏膜病的关系：217例临床分析[J]. 上海口腔医学, 2022, 31(3): 274-281.

ZHOU Yong, ZHOU Zheng-quan, LIU Xue-wei, ZHANG Li-mu, WANG Ye, LIN Xiao-ping. Relationship between peripheral blood micronutrients and four kinds of oral mucosal diseases in children: clinical analysis of 217 cases[J]. Shanghai Journal of Stomatology, 2022, 31(3): 274-281.

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