Ladegaard Grønkjær Lea, Holmstrup Palle, Jepsen Peter, Vilstrup Hendrik
Department of Hepatology and Gastroenterology Aarhus University Hospital Aarhus Denmark.
Department of Gastroenterology Hospital of South West Jutland Aarhus Denmark.
JGH Open. 2021 Jan 12;5(2):294-300. doi: 10.1002/jgh3.12489. eCollection 2021 Feb.
The aims of this study were to describe the prevalence of various oral diseases and to examine the association of the oral diseases with complications and mortality of cirrhosis.
A total of 184 cirrhosis patients were enrolled and were followed up for 2 years. They underwent oral clinical and radiographic examination. At study entry, the associations between oral diseases with nutrition, inflammation, and cirrhosis complication status were examined. Then, the associations of oral diseases with all-cause and cirrhosis-related mortality were examined using Cox regression to adjust for confounding by age, gender, smoking, alcohol use, alcoholic cirrhosis, cirrhosis complications, comorbidity, Child-Pugh, and Model of End-Stage Liver Disease (MELD) score.
At entry, 26% of the patients had gross caries, 46% periapical lesions, 27% oral mucosal lesions, and 68% periodontitis. Having one or more oral diseases was associated with a higher prevalence of cirrhosis complications (46.7 20.5%), higher C-reactive protein (28.5 mg/L 10.4 mg/L), and higher nutritional risk score (4 3). Two-thirds of the patients died during follow-up. The patients with more than one oral disease had an increasingly higher all-cause mortality (two diseases: hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.02-1.98; three and four diseases: HR 1.75, 95% CI 1.05-3.24) and even higher cirrhosis-related mortality (two diseases: HR 1.60, 95% CI 1.01-2.40; three and four diseases: HR 2.04, 95% CI 1.05-8.83) compared to those with no oral disease.
In cirrhosis, having more than one oral disease was associated with more complications and with higher mortality.
本研究旨在描述各种口腔疾病的患病率，并探讨口腔疾病与肝硬化并发症及死亡率之间的关联。
共纳入184例肝硬化患者，随访2年。他们接受了口腔临床和影像学检查。在研究开始时，检查口腔疾病与营养、炎症及肝硬化并发症状态之间的关联。然后，使用Cox回归分析口腔疾病与全因死亡率和肝硬化相关死亡率之间的关联，并对年龄、性别、吸烟、饮酒、酒精性肝硬化、肝硬化并发症、合并症、Child-Pugh评分和终末期肝病模型（MELD）评分等混杂因素进行校正。
研究开始时，26%的患者有严重龋齿，46%有根尖周病变，27%有口腔黏膜病变，68%有牙周炎。患有一种或多种口腔疾病与肝硬化并发症的较高患病率（46.7% 对20.5%）、较高的C反应蛋白（28.5 mg/L对10.4 mg/L）和较高的营养风险评分（4对3）相关。三分之二的患者在随访期间死亡。与无口腔疾病的患者相比，患有不止一种口腔疾病的患者全因死亡率越来越高（两种疾病：风险比[HR] 1.55，95%置信区间[CI] 1.02 - 1.98；三种和四种疾病：HR 1.75，95% CI 1.05 - 3.24），肝硬化相关死亡率甚至更高（两种疾病：HR 1.60，95% CI 1.01 - 2.40；三种和四种疾病：HR 2.04，95% CI 1.05 - 8.83）。
在肝硬化患者中，患有不止一种口腔疾病与更多并发症及更高死亡率相关。
