广西地区异基因造血干细胞移植后患者口腔黏膜健康状况研究  

Oral Mucosa Health Status among Patients after Allogeneic Hematopoietic Stem Cell Transplantation in Guangxi District

作　　者：肖丽婷[1] 彭圆媛[1] 陶人川[1] 赖永榕[2] 

机构地区：[1]广西医科大学附属口腔医院牙周黏膜科,广西南宁530021 [2]广西医科大学第一附属医院血液科

出　　处：《口腔医学研究》2011年第10期881-885,共5页Journal of Oral Science Research

基　　金：国家自然科学基金资助项目(编号:30860313);广西回国基金资助项目(编号:桂科回0639619)

摘　　要：目的:了解广西地区异基因造血干细胞移植后患者的口腔黏膜健康状况,尤其是对慢性移植物抗宿主病(chronic graft-versus-host disease,cGVHD)的口腔表征进行深入分析。方法:调查于广西医科大学一附院行异基因外周血干细胞移植成功并存活的患者69例,以复诊的方式进行病史采集、口腔专科检查,详细记录相关信息进行综合分析。结果:69例存活者中诊断为慢性移植物抗宿主病(cGVHD)者22例,出现口腔表征者14例,口腔内均存在大面积黏膜充血,主要主诉为口腔烂痛、口干,口腔溃疡者10例(71%),7例疼痛影响进食,其中合并网状白色条纹样病损或红斑样病损者8例,合并口腔黏膜起疱者5例;单独表现为网状白色条纹样病损或红斑样病损者1例(7%);念珠菌感染者1例(7%);口干者2例(14%)。对临床表现为苔藓样红白混杂斑纹型患者取相应口腔黏膜部位做活组织病理检查,结果显示:上皮轻度过角化,基底层细胞空泡形成,固有层纤维样变性,血管增生、管腔不规整,淋巴细胞、浆细胞浸润。结论:口腔溃疡、红斑样病损、网状白色条纹样病损等患者多伴有疼痛,唾液分泌减少,提示异基因造血干细胞移植患者发生GVHD常伴有口腔表征。Objective： To understand the oral mucosal health status of the patients after allogeneic hematopoietic stem cell transplantation（HSCT） in Guangxi district,especially to explore the oral manifestation of chronic graft-versus-host disease（cGVHD）.Methods： The medical history records of 109 patients after allogeneic HSCT in the First Hospital of Guangxi Medical University were examined firstly.Among them,69 survivals during the study were included in this study for review of history record and oral examination by specialists for further analyses.Results： Among 109 patients,83.5% patients were founded with early oral mucous inflammation,the average time of the first occurrence of the oral mucosa disease was 8.6 days after transplantation.Among the 69 survivals during the survey,22 patients were diagnosis as chronic GVHD,and 14 out of them showed oral manifestation.Oral ulcerations were observed in 10 patients,and 7 with severe pain.Lichenoid lesions with erosions and erythema were discovered in 8 patients,and 5 cases with vesicle.2 patients with dry mouth syndrom.1 patients had reticular white stripe only,and 1 was diagnosed as oral candidosis.Typical histopathological appearance of lichenoid lesions showed as mild epithelial hyperplasia,lymphocytes infiltration,basal cell hydropic degeneration;fibrosis and local ulceration formed with necrotic exudation.Conclusion： Most of the oral cGVHD patients associated with pain,and reduction of saliva.It suggested that oral lesions were common among patients after HSCT.

关 键 词：干细胞移植 移植物抗宿主病 口腔表征 口腔黏膜 

分 类 号：R781.5[医药卫生—口腔医学]