口腔健康状况对炎症性肠病影响机制的研究进展  

Research progress on the mechanisms of oral health status affectinginflammatory bowel disease

作　　者：郭心如 范渺渺 姜琛 白浩 孟妍 陈立勇 GUO Xinru;FAN Miaomiao;JIANG Chen;BAI Hao;MENG Yan;CHEN Liyong(Department of Nutrition and Food Hygiene,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Department of Health,Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Department of Clinical Nutrition,Qilu Hospital of Shandong University,Jinan 250063,China;Department of Clinical Nutrition,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院营养与食品卫生学系,山东济南250012 [2]山东中医药大学健康学院,山东济南250355 [3]山东大学齐鲁医院临床营养科,山东济南250063 [4]山东第一医科大学附属省立医院临床营养科,山东济南250021

出　　处：《老年医学研究》2025年第2期66-71,共6页Geriatrics Research

摘　　要：炎症性肠病(IBD)作为一种慢性非特异性肠道炎症性疾病,其发病率伴随着人口老龄化逐年增高,已成为一个全球性的健康问题。近年来,越来越多的流行病学证据表明,不良口腔健康状况与IBD的发病存在显著关联,其潜在的机制可能涉及口腔—肠道轴的作用。具体而言,与健康对照个体相比,IBD患者存在口腔微生态的失调,而口腔来源的致病菌可以通过在肠道中的定植来影响肠道微生物群的结构,导致肠道微生态失调,进一步降低定植抗力。口腔致病菌还可以通过在肠道中的异位定植引起肠道内的炎症反应,损伤肠上皮屏障的完整性,进而促进条件性病原体的入侵。此外,非甾体抗炎药物、抗生素、抑酸药物的使用以及饮食营养因素等同样可能介导口腔疾病与IBD之间的关系。鉴于IBD的病因尚未完全阐明,以上因素在影响IBD发生发展的同时,可能存在复杂的相互作用。本文对口腔健康状况与IBD关系的流行病证据、口腔疾病影响IBD的潜在机制展开综述,旨在为IBD的病因学和防治提供新的证据和思路,降低疾病负担。Inflammatory bowel disease(IBD)is a chronic nonspecific inflammatory disease of the gut,and its inci-dence rate is increasing with the aging of the population,making it a global health issue.In recent years,accumulated epi-demiological evidence has indicated a significant association between poor oral health and the risk of IBD,with potential mechanisms involving the role of oral-gut axis.Specifically,IBD patients exhibit dysbiosis of the oral microbiota compared to healthy controls,and the pathogenic bacteria originating from the oral cavity can influence the structure of the gut micro-biome by colonizing the gut leading to dysbiosis and further reducing colonization resistance.Oral pathogenic bacteria can also induce inflammatory responses in the gut through ectopic colonization,damaging the integrity of the intestinal barrier function and promoting the invasion of opportunistic pathogens.Additionally,the use of non-steroidal anti-inflammatory drugs,antibiotics,proton pump inhibitors,and dietary and nutritional factors,may also mediate the relationship between oral diseases and IBD.Given that the etiology of IBD is not yet fully understood,the above factors may influence the occur-rence and development of IBD and may interact with each other in complex ways.This study reviews the epidemiological evidence regarding the relationship between oral health and IBD,the potential mechanisms,and corresponding prevention and treatment strategies,which aims to provide new insights for early screening and prevention of IBD,thereby reducing the disease burden.

关 键 词：炎症性肠病 口腔健康状况 口腔—肠道轴 微生态失调 免疫炎症反应 

分 类 号：R574[医药卫生—消化系统] R781[医药卫生—内科学]