维持性血液透析患者的口腔状况调查  

Investigation of oral status in patients with maintenance hemodialysis

作　　者：王雅君 刘丽[2] 梁如练 谢平[1] 赵晋媛 曹凯[1] 陈舜杰 汪年松[2] 王锋 孙兆琦 WANG Yajun;LIU Li;LIANG Rulian;XIE Ping;ZHAO Jinyuan;CAO Kai;CHEN Shunjie;WANG Niansong;WANG Feng;SUN Zhaoqi(Department of Nephrology,Shanghai Eighth People’s Hospital,Jiangsu University,Shanghai 200235,China;不详)

机构地区：[1]江苏大学附属上海市第八人民医院肾内科,上海200235 [2]上海交通大学医学院附属第六人民医院肾内科 [3]同济大学附属上海市第四人民医院肾内科 [4]江苏大学附属上海市第八人民医院口腔科,上海200235

出　　处：《上海医学》2023年第11期750-757,共8页Shanghai Medical Journal

基　　金：国家自然科学基金(82270761)。

摘　　要：目的 调查维持性血液透析(MHD)患者口腔疾病(即龋齿或牙周炎)的患病情况,并探讨其相关危险因素。方法 选取2021年1-12月上海市3家医院(同济大学附属上海市第四人民医院、上海交通大学医学院附属第六人民医院、江苏大学附属上海市第八人民医院)的血液透析中心的351例MHD患者进行全面的口腔检查,评估其口腔疾病状况。收集资料包括年龄、性别、糖尿病史、高血压病史、MHD持续时间,以及实验室检查结果等。以2015年中华口腔医学会发布的《第四次全国口腔健康流行病学调查报告》(简称《口腔流调》)中一般人群的龋齿和牙周炎患病情况作为对照,与本研究纳入的MHD患者资料进行对比分析。结果 本研究共纳入351例患者,其中男性233例(66.38%),女性118例(33.62%);年龄为(62.8±13.3)岁,血液透析时间为(53.9±55.7)个月;38.46%(135/351)的患者每天刷牙<2次。94.30%(331/351)的患者从未使用过牙线,88.32%(310/351)的患者从未使用过牙签,94.59%(332/351)的患者从未使用过漱口水。6.55%(23/351)的患者近3个月使用过抗生素。近6个月内无患者进行过口腔检查与治疗。排除29例无牙颌患者,龋齿组纳入220例,非龋齿组纳入102例;牙周炎组纳入308例,非牙周炎组纳入14例。在龋齿患病率方面,《口腔流调》结果显示,35~44岁人群的龋齿患病率为62.70%(2 765/4 410),55~64岁人群为72.59%(3 356/4 623),65~74岁人群为76.69%(3 398/4 431);本研究纳入资料显示,35~44岁MHD患者的龋齿患病率为65.38%(17/26),55~64岁MHD患者为63.53%(54/85),65~74岁MHD患者为80.77%(84/104);两组资料中,各年龄段龋齿患病率的差异均分别无统计学意义(P=0.778、0.064、0.330)。在牙周炎患病率方面,《口腔流调》结果显示,35~44岁人群牙周炎的患病率为52.79%(2 328/4 410),55~64岁人群为69.31%(3 204/4 623),65~74岁人群为64.59%(2 862/4 431);本研究纳入资料显示,35~44岁MHD患者的牙周炎患�Objective To investigate the prevalence of oral diseases(dental caries and periodontitis)and risk factors in patients with maintenance hemodialysis(MHD).Methods From January to December,2021,351 patients undergoing MHD in Shanghai Fourth People’s Hospital affiliated to Tongji University,Shanghai Sixth People’s Hospital affiliated to Shanghai Jiao Tong University and Shanghai Eighth People’s Hospital affiliated to Jiangsu University were selected for a comprehensive oral examination.Clinical data including age,gender,history of diabetes,history of hypertension,duration of dialysis,and laboratory indices were collected.The prevalence of dental caries and periodontitis of the patients were compared with the Fourth National Oral Epidemiological Survey issued by the Chinese Society of Stomatology in 2015.Results There were 233(66.38%)males and 118(33.62%)females with a mean age of(62.8±13.3)years.The mean duration of hemodialysis was(53.9±55.7)months.Of the patients,38.46%(135/351)brushed their teeth less than twice a day;94.30%(331/351)had never used dental floss,88.32%(310/351)had never used toothpicks,and 94.59%(332/351)had never used mouthwash.Antibiotics were applied in 6.55%(23/351)of patients in the past 3 months.There was no oral examination or treatment in these patients within the past 6 months.There were 220 patients with dental caries,308 patients with periodontitis and 29 edentulous patients.The prevalence of dental caries was 65.38%(17/26),63.53%(54/85)and 80.77%(84/104)in MHD patients aged 35-44 years,55-64 years and 65-74 years,respectively,which was not significantly different from that in the general population(62.70%[2765/4410],72.6%[3356/4623],76.69%[3398/4431],P=0.778,P=0.064,P=0.330).The prevalence of periodontitis was 84.62%(22/26),95.29%(81/85)and 99.04%(103/104)in MHD patients aged 35-44 years,55-64 years and 65-74 years,respectively,which was significantly higher than that in the general population(52.79%[2328/4410],69.31%[3204/4623],64.59%[2862/4431],P<0.001).There were significant d

关 键 词：维持性血液透析 牙周炎 龋齿 肾功能不全 

分 类 号：R692.5[医药卫生—泌尿科学]