期刊导航

论文摘要

肾移植患者常见的口腔疾病

Common oral diseases in renal transplant patients

作者:陈方曼,宗弋,李宇

Author:Chen Fangman, Zong Yi, Li Yu

收稿日期:2014-09-18          年卷(期)页码:2015,42(5):611-614

期刊名称:国际口腔医学杂志

Journal Name:International Journal of Stomatology

关键字:肾移植,口腔疾病,免疫抑制剂,

Key words:kidney transplantation,oral disease,immunosuppressants,

基金项目:

国家自然科学基金(11372202)

中文摘要

为降低机体的免疫排斥反应,确保移植肾的功能,肾移植患者需长期接受环孢素、他克莫司和西罗莫司等免疫抑制剂治疗。这些药物直接影响细胞代谢,促进牙龈成纤维细胞增殖,致患者药物性牙龈增生。同时,肾移植患者免疫力低下,对病原微生物抵抗力较弱,易致口腔菌斑聚积,罹患牙龈炎甚至牙周炎;而口腔黏膜则易罹患白假丝酵母菌和单纯疱疹病毒感染,罹患毛状白斑、裂纹舌、唇癌和口腔浅表溃疡等疾病。在肾移植术1年后,患者的患龋率增高,可能系免疫抑制剂致唾液中IgA水平下降。30.43%的肾移植患者存在着颌骨畸形,同样可能系免疫抑制剂所致。肾移植术后并发的口腔疾病,不仅影响口腔功能和颜面美观,严重者甚至诱发心血管疾病、糖尿病、消化道疾病等全身疾病。了解肾移植患者与口腔疾病间的关系,有针对性地选择制定治疗措施,可降低治疗中的不良反应,降低口腔及其他器官系统疾病的发生率,提高其生命质量。

英文摘要

To reduce immune rejection and maintain normal function of the kidneys, patients with transplanted renal need immunosuppressive agents, such as cyclosporine, tacrolimus, and sirolimus for the long term. These drugs directly influence cell metabolism and facilitate the proliferation of fibroblasts, thereby leading to drug-induced gingival overgrowth. Patients with low immunity are vulnerable to pathogens, are more likely to develop plaque deposits, and have gingivitis or periodontitis. As for oral mucous, these patients are susceptible to infections of Candida albicans or herpes simplex virus and have diseases like hairy leukoplakia, fissured tongue, lip cancer, and ulcers. One year after renal transplantation, higher prevalence of caries is observed, which may be related to low salivary Immunoglobulin A levels caused by immunosuppressive agents. Patients(30.43% of the total) have jaw deformities, which may also be related to immunosuppressive agents. These oral diseases not only affect oral functions, such as mastication, pronunciation, and esthetic appearance, but also cause severe systemic diseases like diabetes mellitus, cardiovascular diseases, and digestive tract diseases. Knowing the relationship between renal transplants and oral diseases and choosing an appropriate medication could help reduce drug-related side effects, decrease the prevalence of oral or other systematic diseases, and improve the quality of life of renal transplant patients.

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