Main B E, Calman K C, Ferguson M M, Kaye S B, MacFarlane T W, Mairs R J, Samaranayake L P, Willox J, Welsh J
Oral Surg Oral Med Oral Pathol. 1984 Nov;58(5):545-8. doi: 10.1016/0030-4220(84)90077-x.
Oral complications of cytotoxic therapy result from direct mucosal damage and, indirectly, occur as a consequence of immunosuppression. Such problems are further exacerbated as a result of associated xerostomia and secondary infection. Therefore, the aims of this study were to examine the salivary volume and composition (amylase, IgA, and lysozyme) together with the oral carriage of potential pathogens in patients receiving cytotoxic therapy. A pilot study comparing healthy controls with patients on chemotherapy for malignant conditions indicated that there were differences between the two groups. Therefore, a longitudinal study was initiated and twelve patients were assessed prior to and 4 and 12 weeks after the start of cytotoxic therapy. The 10-minute forced-spitting salivary volume and amylase and IgA levels all declined significantly over the 12-week period. Lysozyme content did not change. A quantitative increase in the oral carriage of Candida species, coliforms, and Staphylococcus aureus was also observed during therapy. Hence, it is concluded that cytotoxic chemotherapy results in a decreased salivary flow, a reduction in salivary amylase and IgA, and an increase in the oral carriage of opportunistic pathogens.
细胞毒性疗法的口腔并发症源于直接的黏膜损伤，间接则是免疫抑制的结果。由于相关的口干症和继发感染，这些问题进一步恶化。因此，本研究的目的是检查接受细胞毒性疗法的患者的唾液量和成分（淀粉酶、免疫球蛋白A和溶菌酶）以及潜在病原体的口腔携带情况。一项将健康对照者与接受恶性疾病化疗的患者进行比较的初步研究表明，两组之间存在差异。因此，启动了一项纵向研究，对12名患者在细胞毒性疗法开始前、开始后4周和12周进行评估。在12周期间，10分钟强制吐唾液量以及淀粉酶和免疫球蛋白A水平均显著下降。溶菌酶含量未发生变化。在治疗期间还观察到念珠菌属、大肠菌群和金黄色葡萄球菌的口腔携带量定量增加。因此，得出结论，细胞毒性化疗导致唾液流量减少、唾液淀粉酶和免疫球蛋白A降低，以及机会性病原体的口腔携带量增加。
