Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland.
Hepatol Res. 2014 Mar;44(3):349-53. doi: 10.1111/hepr.12126. Epub 2013 Apr 29.
Dental infections are implicated in several systemic diseases due to bacteremia and pro-inflammatory effects, but their possible role in liver disease is unclear.
We retrospectively analyzed the clinical course of liver disease in relation to dental health among 116 patients with liver cirrhosis who underwent dental examination before liver transplantation.
The need for multiple tooth extractions, a surrogate marker of dental infections, was associated with reduced time from diagnosis of liver disease to the need for liver transplantation (P = 0.02). The association was independent of age, sex, liver disease etiology and Model for End-Stage Liver Disease (MELD) score (P = 0.04). Among 38 patients with accurate laboratory follow-up data, the number of tooth extractions correlated with the change in MELD score during the year preceding dental examination (r = 0.43, P = 0.03). Spontaneous bacterial peritonitis caused by Streptococcus viridans occurred only among patients with multiple dental infections.
Dental infections may influence the clinical course of liver disease, but prospective studies are needed.
由于菌血症和促炎作用，口腔感染与多种全身疾病有关，但它们在肝病中的可能作用尚不清楚。
我们回顾性分析了 116 例接受肝移植前牙科检查的肝硬化患者的肝病临床过程与口腔健康的关系。
需要多次拔牙，作为口腔感染的替代标志物，与从诊断为肝病到需要肝移植的时间缩短相关（P=0.02）。这种关联独立于年龄、性别、肝病病因和终末期肝病模型（MELD）评分（P=0.04）。在有准确实验室随访数据的 38 例患者中，拔牙数量与牙科检查前一年 MELD 评分的变化相关（r=0.43，P=0.03）。仅在患有多种牙科感染的患者中发生由草绿色链球菌引起的自发性细菌性腹膜炎。
口腔感染可能会影响肝病的临床过程，但需要前瞻性研究。
