腺周口疮的回顾性队列研究  

Retrospective cohort study of major recurrent aphthous ulcer at different ages

作　　者：刘子建 韩莹[1] 金建秋[1,2] 郭骧 李曼 苏莎[1,5] 程喆[1,2] 刘晓丹[1,6] 徐偲 鲁明星[1] 李淑芳[1] 刘行云 郭倩云 王雨田 刘宏伟 LIU Zi-jian;HAN Ying;JIN Jian-qiu;GUO Xiang;LI Man;SU Sha;CHENG Zhe;LIU Xiao-dan;XU Si;LU Ming-xing;LI Shu-fang;LIU Xing-yun;GUO Qian-yun;WANG Yu-tian;LIU Hong-wei(Department of Oral Mucosa,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology,Beijing 100081,China;Department of Stomatology,Beijing Hospital,Beijing 100005,China;Department of Stomatology,Beijing Zhongguancun Hospital,Chinese Academy of Sciences,Beijing 100080,China;Department of Stomatology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Stomatology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Stomatology,the Third Hospital of Peking University,Beijing 100083,China;Department of Stomatology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]北京大学口腔医学院·口腔医院口腔黏膜科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,北京100081 [2]北京医院口腔科,北京100005 [3]中国科学院北京市中关村医院口腔科,北京100080 [4]中日友好医院口腔科,北京100029 [5]首都医科大学附属北京友谊医院口腔科,北京100050 [6]北京大学第三医院口腔科,北京100083 [7]首都医科大学附属北京朝阳医院口腔科,北京100020

出　　处：《临床口腔医学杂志》2022年第7期399-403,共5页Journal of Clinical Stomatology

基　　金：国家自然科学基金项目(81771071,U19A2005)。

摘　　要：目的:比较不同年龄患者的重型复发性阿弗他溃疡(major recurrent aphthous ulcer,MaRAU)(又称腺周口疮)的临床特征。方法:选择2009年1月~2018年12月于北京大学口腔医院就诊并完成≥3年随访的MaRAU患者,收集病史、溃疡的严重程度(病程、年总间歇时间、年总溃疡个数和年总溃疡面积)、MaRAU的好发部位、伴发或后遗症状及随访期内新出现的全身疾病等信息。结果:共纳入60例MaRAU患者,按MaRAU的发病年龄是否超过40岁分成早发病和迟发病2组,34例纳入早发病组,26例纳入迟发病组。2组的一般情况、相关病史及药物选择上无明显差异。早发病者的MaRAU更好发于口咽部(P=0.022),其溃疡严重程度更高(P<0.050),更易出现张口受限(P=0.011)和吞咽困难(P=0.031),且其中有11例患者(32.4%)出现肠道疾病,显著多于迟发病组(RR=4.206,95%CI:1.019~117.356,P=0.022)。Logistic回归分析显示年龄小于40岁(P=0.021)和MaRAU出现前经常腹泻(P=0.022)是MaRAU发病后出现肠道疾病的危险因素。结论:年轻的MaRAU患者口腔溃疡更为严重,且更容易出现肠道疾病,应积极治疗口腔溃疡,且重视肠道疾病的排查。Objective:To compare the clinical characteristics of major recurrent aphthous ulcer(MaRAU)in different ages.Methods:Patients with MaRAU who were admitted to Peking University Stomatological Hospital from January 2009 to December 2018 and completed over 3 years follow-up were included in the analysis.The relevant medical history,ulcer severity(course of disease,total annual interval,total annual number of ulcers,and total annual area of ulcers),MaRAU site,accompanying symptoms or sequelae,and new systemic diseases during the follow-up period were collected.Results:A total of 60 MaRAU patients were collected.According to whether the onset age of MaRAU was over 40 years old,the patients were divided into two groups:early onset group(n=34)and late onset group(n=26).There were no significant differences in general condition,related medical history and drug selection between the two groups.The early onset patients were more likely to have MaRAU in the oropharynx( P= 0. 022) ,had higher ulcer severity( P<0. 050) ,mouth opening restriction( P= 0. 011) and dysphagia(P= 0. 031) were more common, and among them,11 patients( 32. 4%) had intestinal disease, significantly more thanthose late onset patients( RR= 4. 206, 95%CI: 1. 019~ 117. 356,P= 0. 022) .Logistic regression showed that age less than 40years( P= 0. 021) and frequent diarrhea before MaRAU( P= 0. 022) were risk factors for intestinal disease after MaRAU onset.Conclusion: Young MaRAU patients had more severe ulcers and a greater impact on daily life, and were more prone to intestinaldiseases in the future.Therefore, attention should be paid to treatment of oral ulcers and early detection for intestinal diseases.

关 键 词：腺周口疮 复发性阿弗他溃疡 临床特征 全身疾病 肠道疾病 

分 类 号：R781.5[医药卫生—口腔医学]