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中性粒细胞减少的强度和持续时间与血液系统恶性肿瘤化疗期间口腔黏膜炎的发生有关,但与牙源性感染无关。

Intensity and duration of neutropenia relates to the development of oral mucositis but not odontogenic infection during chemotherapy for hematological malignancy.

作者信息

Kishimoto Megumi, Akashi Masaya, Tsuji Kazuyuki, Kusumoto Junya, Furudoi Shungo, Shibuya Yasuyuki, Inui Yumiko, Yakushijin Kimikazu, Kawamoto Shinichiro, Okamura Atsuo, Matsuoka Hiroshi, Komori Takahide

机构信息

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

出版信息

PLoS One. 2017 Jul 27;12(7):e0182021. doi: 10.1371/journal.pone.0182021. eCollection 2017.

Abstract

BACKGROUND

D-index which combines the intensity and duration of neutropenia is reported as a tool for evaluating the dynamics of neutropenia. This study aimed to analyze the relationship between D-index and oral complications (i.e., oral mucositis [OM] and odontogenic infection [OI]) during chemotherapies for hematological malignancies.

METHODS

A total of 421 chemotherapeutic courses in 104 patients were analyzed. Chemotherapeutic courses in patients who finished all of the prophylactic dental treatments were defined as "treatment Finish". Chemotherapeutic courses in patients who did not finish prophylactic dental treatments were defined as "treatment not-Finish". OM was evaluated according to the Common Terminology Criteria for Adverse Events, version 4.0. D-index was compared between chemotherapeutic courses with versus without oral complications.

RESULTS

D-index was significantly higher in chemotherapeutic courses with grade 1 or 2 OM (p < 0.001) than courses without OM. In contrast, higher D-index did not relate to the development of OI (p = 0.18). The occurrence of OI (p < 0.001) but not OM (p = 0.56) during chemotherapy was significantly higher in chemotherapeutic courses without the completion of dental intervention.

CONCLUSIONS

Higher D-index relates to the development of OM. In contrast, OI occurs due to untreated odontogenic foci, and its occurrence does not relate to higher D-index.

摘要

背景

D指数结合了中性粒细胞减少的强度和持续时间,被报道为评估中性粒细胞减少动态变化的一种工具。本研究旨在分析血液系统恶性肿瘤化疗期间D指数与口腔并发症(即口腔黏膜炎[OM]和牙源性感染[OI])之间的关系。

方法

对104例患者的421个化疗疗程进行了分析。完成所有预防性牙科治疗的患者的化疗疗程被定义为“治疗完成”。未完成预防性牙科治疗的患者的化疗疗程被定义为“治疗未完成”。根据不良事件通用术语标准第4.0版评估口腔黏膜炎。比较有和没有口腔并发症的化疗疗程之间的D指数。

结果

1级或2级口腔黏膜炎的化疗疗程中的D指数显著高于无口腔黏膜炎的疗程(p<0.001)。相比之下,较高的D指数与牙源性感染的发生无关(p=0.18)。在未完成牙科干预的化疗疗程中,化疗期间牙源性感染的发生率(p<0.001)显著高于口腔黏膜炎(p=0.56)。

结论

较高的D指数与口腔黏膜炎的发生有关。相比之下,牙源性感染是由于未治疗的牙源性病灶引起的,其发生与较高的D指数无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c087/5531589/a337d8c7b818/pone.0182021.g001.jpg

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