口腔扁平苔藓患者心理因素与唾液皮质醇的相关性  

The study of the association between psychological factors and salivary cortisol level in patients with oral lichen planus

作　　者：莫珩[1] 高承志[1] 

机构地区：[1]北京大学人民医院口腔科,北京市100044

出　　处：《中国组织工程研究》2014年第B12期147-149,共3页Chinese Journal of Tissue Engineering Research

摘　　要：背景：口腔扁平苔藓的病因和发病机制目前尚不明确。唾液皮质醇近年来被认为是评价肾上腺皮质功能敏感性和特异性较高的一线指标之一。目的：探讨口腔扁平苔藓患者的焦虑、抑郁心理量表评分与唾液皮质醇水平的相关性。方法：采用汉密尔顿焦虑量表、汉密尔顿抑郁量表评定40例非糜烂型口腔扁平苔藓患者、31例糜烂型口腔扁平苔藓患者与对照组31例的心理因素，并在早晨采集唾液，通过放免法来进行唾液皮质醇的测定。结果与结论：糜烂型口腔扁平苔藓组的汉密尔顿焦虑量表得分（20．77±7．27）分，汉密尔顿抑郁量表得分（11．90±4．68）分，唾液皮质醇浓度（16．50±6．34）ng／mL，均明显高于对照组（P〈0．01）。而非糜烂型口腔扁平苔藓组的汉密尔顿焦虑量表得分（13．43±6．54），汉密尔顿抑郁量表得分（9．58±4．20），唾液皮质醇浓度（10．81±4．78）ng／mL，与对照组相比，差异无显著性意义（P〉0．05）。此外，糜烂型1：3腔扁平苔藓组的唾液皮质醇浓度与汉密尔顿焦虑量表得分（r=0.965）和汉密尔顿抑郁量表得分（r=0．923）呈正相关，非糜烂型口腔扁平苔藓组的唾液皮质醇浓度与汉密尔顿焦虑量表得分（r=0．963）和汉密尔顿抑郁量表得分（r=0．957）亦呈正相关。结果证实，糜烂型口腔扁平苔藓的发生、发展与焦虑、抑郁等情绪障碍有关，其作用机制可能是通过应激反应导致糜烂型口腔扁平苔藓患者的皮质醇升高。这一结论支持了关于口腔扁平苔藓的神经内分泌的病因学。OBJECTIVE： The aim of the study was to explore the relationship between scores of anxiety, depression and the salivary levels of cortisol in patients with oral lichen planus （OLP）. METHODS： 31 patients with EOLP, 40 patients with non-EOLP and 31 control patients were investigated by the instruments Hamilton Anxiety Scale and Hamilton Depression Scale, respectively. Saliva was collected in the morning for the determination of cortisol levels by radioimmunoassay. RESULTS and CONCLUSION： The scores of HAMA （20.77±7.27） and HAMD （11.90±4.68）in patients with EOLP were significant higher than those in the control group （P 〈 0.01）. Significantly higher concentration of salivary cortisol was observed in patients with EOLP （16.50±6.34） ng/mL than in the controls, P 〈 0.01 .The scores of HAMA （13.43±6.54）and HAMD （9.58±4.20）,the concentration of salivary cortisol （10.81±4.78 pg/L）in patients with non-EOLP were not significant higher than those in the control group（P 〉 0.05）. In addition, the concentration of salivary cortisol in patients with EOLP was positively correlated with their scores of HAMA （r=0.965） and HAMD （r=0.923）. The concentration of salivary cortisol in patients with non-EOLP was also positively correlated with their cores of HAMA （r=0.963） and HAMD （r=0.957）. The association between the pathogenesis and exacerbation of EOLP and the mood obstacle can be inferred in the present study. Anxiety and depression may result in higher concentration of salivary cortisol in patienst with EOLP by means of psychosomatic response to stress, which does SUDDOrt the neuroendocrine aetiology for OLP.

关 键 词：组织工程 口腔扁平苔藓 焦虑 抑郁 唾液皮质醇 

分 类 号：R781.59[医药卫生—口腔医学]