中国成年心脏移植受者的口腔健康状况：一项横断面研究。

Oral health status of adult heart transplant recipients in China: A cross-sectional study.

作者信息

Cao Ying, Chen Xi, Jia Yixin, Lv Yalin, Sun Zheng

机构信息

Beijing Stomatological Hospital Department of Stomatology, Beijing Anzhen Hospital, Capital Medical University, Beijing City, China Department of Preventive and Community Dentistry, University of Iowa, Iowa City Department of Cardiac Surgery, Beijing Anzhen Hospital Department of Oral Mucosal Diseases, Beijing Stomatological Hospital, Capital Medical University, Beijing City, China.

出版信息

Medicine (Baltimore). 2018 Sep;97(38):e12508. doi: 10.1097/MD.0000000000012508.

DOI:10.1097/MD.0000000000012508

PMID:30235763

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6160112/

Abstract

Limited information on the oral health status of adult heart transplant recipients (HTRs) is known, and no available data exist in China. A prerequisite dental evaluation is usually recommended for patients' postorgan transplantation because lifelong immunosuppression may predispose them to infection spread.The aim of this study was to investigate the oral health status of Chinese adult HTRs and determine the association between oral health status and history of heart transplantation (HT).We carried out a cross-sectional study to collect clinical, demographic, socioeconomic, and behavioral data from 81 adult patients who received heart transplantation during 2014 to 2015 in China. Clinical examinations for the presence of dental plaque, dental calculus, dental caries, and periodontal health conditions were performed in a standardized manner by one trained examiner. Sociodemographic, socioeconomic, and behavioral data were self-reported using questionnaires. The prevalence of the above conditions was compared with 63 age- and sex-matched controls. General liner regression analysis was used to assess associations between mean number of decayed, missing, and filled teeth (DMFT) and mean community periodontal index of treatment needs (CPITN) scores and history of heart transplant.Mean age of the HT group was 47.7 ± 12.2 years and men accounted for 69.1% of the sample. The overall median DMFT score in the HT group was 3 (1-5) and caries prevalence was 80.2%, which were similar to the control group (P > .05). The overall mean CPITN score of the HT group was 1.84, which was significantly higher than the control group (1.07, P = .001). Participants in the HT group had worse oral hygiene status and more teeth with probing depth ≥ 4 mm than controls (P = .043). Compared with participants who had no history of heart transplantation, HTRs presented worse periodontal health conditions (mean CPITN score, adjusted odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.12-1.71, P = .003) and similar dental caries status (DMFT score, adjusted OR = 0.58, 95% CI = 0.37-0.91, P = .058).Periodontal health status was positively associated with history of heart transplantation in Chinese adult HTRs.

摘要

目前关于成年心脏移植受者（HTRs）口腔健康状况的信息有限，且中国尚无可用数据。通常建议对器官移植后的患者进行术前牙科评估，因为终身免疫抑制可能使他们更容易发生感染扩散。本研究的目的是调查中国成年HTRs的口腔健康状况，并确定口腔健康状况与心脏移植（HT）病史之间的关联。我们进行了一项横断面研究，收集了2014年至2015年期间在中国接受心脏移植的81例成年患者的临床、人口统计学、社会经济和行为数据。由一名经过培训的检查人员以标准化方式进行牙菌斑、牙结石、龋齿和牙周健康状况的临床检查。社会人口统计学、社会经济和行为数据通过问卷调查进行自我报告。将上述情况的患病率与63名年龄和性别匹配的对照组进行比较。采用一般线性回归分析评估龋失补牙面均数（DMFT）和社区牙周治疗需求指数（CPITN）得分均值与心脏移植病史之间的关联。HT组的平均年龄为47.7±12.2岁，男性占样本的69.1%。HT组的总体DMFT中位数为3（1 - 5），龋齿患病率为80.2%，与对照组相似（P>0.05）。HT组的总体CPITN平均得分为1.84，显著高于对照组（1.07，P = 0.001）。HT组参与者的口腔卫生状况比对照组差，且探诊深度≥4mm的牙齿更多（P = 0.043）。与无心脏移植病史的参与者相比，HTRs的牙周健康状况更差（CPITN得分均值，校正比值比（OR）= 1.39，95%置信区间（CI）= 1.12 - 1.71，P = 0.003），而龋齿状况相似（DMFT得分，校正OR = 0.58，95% CI = 0.37 - 0.91，P = 0.058）。在中国成年HTRs中，牙周健康状况与心脏移植病史呈正相关。