Bienengräber V, Teseler R M, Anders O
Klinik und Polikliniken für Zahn-, Mund- und Kieferheilkunde, Universität Rostock.
Mund Kiefer Gesichtschir. 1997 Nov;1(6):346-8. doi: 10.1007/BF03043581.
The aim of this study is the registration and the chronological control of inflammatory alterations in the oral mucosa of patients with acute leukaemia under cytostatic treatment. Thirteen patients with acute myeloid leukaemia or acute lymphatic leukaemia were investigated in three oral regions (gingiva, buccal and palatine mucosa) before, during and after cytotoxic drug application for a period of 4-6 weeks by means of exfoliative cytology. Before therapy, patients with leukaemia showed a significant increase in the number of cells from deeper epithelial layers and a significant decrease of the keratinization index for all investigated regions. This is a consequence of the general inflammatory alteration in all mucosal areas. During cytotoxic drug application these findings were modified only for the palatine mucosa. Immediately after the end of cytotoxic drug application only the buccal mucosa showed a slight but not significant tendency for normalization. At this time, only for the palatine mucosa was there a significant tendency toward regression. The study underlines the necessity for intensive dental care of patients with acute leukaemia after treatment with cytotoxic drug, even when the oral mucosa is clinically inconspicuous, as the inflammatory activity may take place subclinically in strongly stressed or vulnerable regions of mucosa.
本研究的目的是对接受细胞抑制治疗的急性白血病患者口腔黏膜的炎症改变进行记录和时序控制。通过脱落细胞学方法，对13例急性髓细胞白血病或急性淋巴细胞白血病患者在应用细胞毒性药物前、用药期间及用药后4至6周内的三个口腔区域（牙龈、颊黏膜和腭黏膜）进行了研究。治疗前，白血病患者所有被研究区域的深层上皮细胞数量显著增加，角化指数显著降低。这是所有黏膜区域普遍炎症改变的结果。在应用细胞毒性药物期间，这些发现仅在腭黏膜有所改变。细胞毒性药物应用结束后，即刻只有颊黏膜显示出轻微但不显著的恢复正常的趋势。此时，只有腭黏膜有显著的恢复趋势。该研究强调，急性白血病患者在接受细胞毒性药物治疗后，即使口腔黏膜在临床上无明显异常，也有必要进行强化口腔护理，因为炎症活动可能在黏膜压力大或易受损的区域以亚临床形式发生。
