Yang Yafeng, Duan Li, Ding Xiaoyan, Yang Xinghua, Yang Yuxin, Zhao Ziang, Ma Yanan, Li Ruimin
Department of Dental and Endodontic Diseases, Stomatological Hospital, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia Hui Autonomous Region, China.
School of Stomatology, Ningxia Medical University, Yinchuan City, Ningxia Hui Autonomous Region, China.
Int Dent J. 2025 Aug 21;75(5):100959. doi: 10.1016/j.identj.2025.100959.
To investigate the impact of dental caries and odontogenic infections on pediatric patients with Henoch-Schönlein purpura (HSP), and to preliminarily explore the relationship between dental caries and the progression of HSP in these patients.
From September 2021 to September 2022, 45 pediatric patients diagnosed with HSP at our hospital, were enrolled in this clinical study. The patients were divided into three groups: Group A (HSP without dental caries, n = 12), Group B (HSP with dental caries, n = 18), and Group C (HSP with dental caries receiving systematic treatment for dental caries, n = 15). Clinical indicators and the recurrence of HSP were monitored at a 3-month follow-up. Additionally, the 16S rDNA high-throughput sequencing technique was used to analyze changes in the composition and diversity of oral microbiota in the saliva and dental plaque of the patients.
Compared to discharge, Group B showed a significant increase in urinary protein (PRO) at the 3-month follow-up (P < .05), while Group C demonstrated a notable increase in red blood cell count (RBC) and hemoglobin (HGB), along with a significant decrease in red cell distribution width coefficient of variation (RDW-CV), monocyte count, and urinary white blood cell count (UWBC) (all P < .05). The oral microbiota composition across the three groups was largely similar. However, compared to HSP patients without dental caries, those with dental caries exhibited an increased abundance of Prevotella and Streptococcus mutans, along with a trend toward reduced oral microbiota diversity. After systematic treatment for dental caries, there was a significant increase in oral microbiota diversity as measured by the Shannon index (P < .05).
Oral examinations and early systematic dental treatments for pediatric patients with HSP can enhance oral microbiome diversity, mitigate the impact of odontogenic foci on systemic health, and may help reduce the recurrence rate of HSP and the risk of nephritis complications.
探讨龋齿和牙源性感染对小儿过敏性紫癜（HSP）患者的影响，并初步探究这些患者中龋齿与HSP病情进展之间的关系。
2021年9月至2022年9月，我院45例诊断为HSP的小儿患者纳入本临床研究。患者分为三组：A组（无龋齿的HSP患者，n = 12）、B组（有龋齿的HSP患者，n = 18）和C组（有龋齿且接受龋齿系统治疗的HSP患者，n = 15）。在3个月随访时监测临床指标及HSP复发情况。此外，采用16S rDNA高通量测序技术分析患者唾液和牙菌斑中口腔微生物群的组成及多样性变化。
与出院时相比，B组在3个月随访时尿蛋白（PRO）显著增加（P < 0.05），而C组红细胞计数（RBC）、血红蛋白（HGB）显著增加，同时红细胞分布宽度变异系数（RDW-CV）、单核细胞计数及尿白细胞计数（UWBC）显著降低（均P < 0.05）。三组口腔微生物群组成大致相似。然而，与无龋齿的HSP患者相比，有龋齿的患者普雷沃菌属和变形链球菌丰度增加，且口腔微生物群多样性有降低趋势。龋齿系统治疗后，香农指数测量的口腔微生物群多样性显著增加（P < 0.05）。
对HSP小儿患者进行口腔检查及早期系统牙科治疗可增强口腔微生物群多样性，减轻牙源性病灶对全身健康的影响，并可能有助于降低HSP复发率及肾炎并发症风险。
