涎腺结石的形成过程及其机制  

The development and mechanism of the sialoliths

作　　者：尉华杰[1] 柳登高[1] 

机构地区：[1]北京大学附属口腔医院放射科,北京100081

出　　处：《国际口腔医学杂志》2011年第5期596-599,共4页International Journal of Stomatology

摘　　要：涎石病是涎腺常见的疾病,主要累及大涎腺。当腺体发生涎石阻塞时,会出现与进食相关的肿胀、疼痛等症状。随着内窥镜技术的发展,可以对涎石进行直视下的诊断和治疗,创伤也更小。但是关于涎石的病因学及确切的形成机制目前尚不明确,本文就涎腺结石形成的过程及机制进行综述。结石通常是由矿化的内核及外周层状结构所构成。机体在刺激因素作用下,引起一系列的免疫应答,导致了腺管收缩和涎液滞留等,激化了涎石的形成。这个过程中,多重因素可以影响涎石的形成;包括分泌的紊乱(微小结石的形成、涎腺导管缩窄阻塞和导管的解剖异常)和涎液成分的改变(钙化物的过饱和状态、结晶抑制剂的缺乏、pH值的变化以及细菌与蛋白酶成分的改变)。Sialolithiasis is a common disease of salivary glands,mainly afflicting the major salivary glands.Characterized by the obstruction of the salivary secretion by a calculus,its main symptoms are recurrent swelling and pain,and may be aggravated during eating.Owing to the rapid developments in endoscopic techniques,it is now possible to perform diagnostic and interventional procedures directly within the salivary ductal system with less invasiveness.The etiology of these calculi and the exact mechanism of formation,however,are unclear.Sialoliths are composed of a central mineralized core and laminar layers of organic and inorganic substances.Irritant factors trigger a response and cause spasmodic contraction of the canal and stasis of saliva and then lead to the development of calculus.During the development of sialoliths,multi-factorial events can be involved,including secretory disturbances（microlith formation,ductal obstruction and anatomical abnormity） and influence of saliva（high calcium affinity,decreased concentration of crystallisation inhibitors,influence of pH,diversification of bacteria and components of protease）.

关 键 词：涎石病 形成机制 病因 

分 类 号：R781.75[医药卫生—口腔医学]