口腔扁平苔藓患者情绪障碍与唾液皮质醇和脱氢表雄酮水平的相关性  

Association between the mood obstacle and salivary cortisol,DHEA levels in patients with oral lichen planus

作　　者：莫珩[1] 高承志[1] 王少杰[2] 曲姗[3] 

机构地区：[1]北京大学人民医院口腔科,北京100044 [2]北京大学人民医院中医科,北京100044 [3]北京大学人民医院心理科,北京100044

出　　处：《郑州大学学报（医学版）》2015年第6期818-822,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金资助项目81273712

摘　　要：目的:探讨口腔扁平苔藓(OLP)患者情绪障碍与唾液皮质醇和脱氢表雄酮(DHEA)水平的相关性。方法:采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评定非糜烂型OLP组(40例)、糜烂型OLP组(31例)和对照组(31例)的焦虑、抑郁状况,并在早晨采集唾液,通过放射免疫法对受试者的唾液皮质醇和DHEA水平进行测定,分析量表得分与唾液皮质醇和DHEA水平的相关性。结果:3组受试者的HAMA得分、HAMD得分、唾液皮质醇水平差异均有统计学意义(F=15.892、4.876和14.375,P<0.05),糜烂型OLP组HAMA得分、HAMD得分、唾液皮质醇水平均高于对照组和非糜烂型OLP组(P<0.05)。糜烂型OLP组唾液皮质醇水平与HAMA得分和HAMD得分(r=0.965、0.923,P<0.001)呈正相关,而唾液DHEA水平与HAMA得分和HAMD得分(r=-0.948、-0.966,P<0.001)呈负相关。非糜烂型OLP组唾液皮质醇水平与HAMA得分和HAMD得分(r=0.963、0.957,P<0.001)呈正相关,而唾液DHEA水平与HAMA得分和HAMD得分(r=-0.962、-0.971,P<0.001)呈负相关。结论:糜烂型OLP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OLP患者的唾液皮质醇水平升高,但是否与唾液DHEA水平的降低相关还有待进一步的研究。Aim：To explore the relationship between scores of anxiety , depression and the salivary levels of cortisol , DHEA in patients with oral lichen planus （ OLP） .Methods：Thirty-one patients with erosive oral lichen planus （ 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 , DHEA levels by radio-immunoassay to explore the relationship between scores of anxiety , depression and the salivary levels of cortisol , DHEA in the three groups .Results：There were significant differences in the scores of HAMA , HAMD and the concentration of sali-vary cortisol of objects in three groups （F=15.892,4.876 and 14.375,P〈0.05）.Compared with controls and patients with non-EOLP, the scores of HAMA , HAMD and the concentration of salivary cortisol in patients with EOLP were signifi-cantly higher（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,P〈0.001） and HAMD （r =0.923,P〈0.001）.The concentration of salivary DHEA in patients with EOLP was negatively correlated with their scores of HAMA （ r=-0.948,P〈0.001） and HAMD （r=-0.966,P〈0.001）.The concentration of salivary cortisol in patients with non-EOLP was positively correlated with their cores of HAMA （r=0.963,P〈0.001） and HAMD （r=0.957,P〈0.001）.The concentration of salivary DHEA in patients with non-EOLP was negatively correlated with their scores of HAMA （ r =-0.962, P 〈0.001 ） and HAMD （r=-0.971,P〈0.001）.Conclusion：The pathogenesis and exacerbation of EOLP could be inferred by the mood obsta-cle.Anxiety and depression may result in higher concentration of salivary cortisol in patients with EOLP by means of psy -chosomatic response to stress .While the relation between anxiety , depression and lower salivary DHEA levels in patients with EOLP

关 键 词：口腔扁平苔藓 焦虑 抑郁 唾液皮质醇 唾液脱氢表雄酮 

分 类 号：R781.5[医药卫生—口腔医学]