活动期克罗恩病患者口腔黏膜病变的前瞻性研究

Przeglad lekarski Pub Date : 2017-01-01
Katarzyna Szczeklik, Jolanta Pytko-Polończyk, Dorota Cibor, Danuta Owczarek, Tomasz Mach
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Mucosal lesions in the oral cavity\nare described in various populations,\nbut observations in active disease\nwith severe clinical symptoms are\nquite rare.</p><p><strong>Objectives: </strong>To evaluate the prevalence\nand nature of oral mucosa lesions\nin adult patients with active CD\nand their correlation with clinical and\nlaboratory indicators of disease activity.</p><p><strong>Material and methods: </strong>Prospective\nstudy was performed in 62 patients\n(29 women, 33 men, age 18-49 years)\nadmitted between December 2010 and\nFebruary 2013 to the gastroenterology\ndepartment with a confirmed diagnosis\nof CD and exacerbations of symptoms,\nand 40 sex- and gender-matched\nhealthy volunteers. CD activity was\nclassified according to clinical and\nblood parameters, and the CD activity\nindex (CDAI). We examined: blood morphology,\nhemoglobin and CRP levels,\nBMI. 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引用次数: 0

摘要

简介:克罗恩病(CD)是一种慢性炎症性疾病,可累及胃肠道的任何部位,包括口腔。口腔粘膜病变在各种人群中都有报道,但在有严重临床症状的活动性疾病中观察到的情况相当罕见。目的:探讨成人活动性cdp患者口腔黏膜病变的发生率、性质及其与临床、实验室疾病活动性指标的相关性。材料和方法:前瞻性研究纳入了2010年12月至2013年2月期间肠胃科确诊为乳糜泻和症状加重的62例患者(29例女性,33例男性,年龄18-49岁),以及40名性别和性别匹配的健康志愿者。根据临床和血液指标及CD活性指数(CDAI)对CD活性进行分类。我们检查了:血液形态,血红蛋白和CRP水平,BMI。口腔检查包括详细的面谈和体格检查,根据世界卫生组织的建议。结果:在activeCD患者中,我们发现:与对照组相比,CDAIscore(258.4±21.5)升高,CRP水平(24.6±1.3 mg/l)和血小板计数升高,贫血,RBC和血红蛋白水平显著降低,BMI降低。乳糜泻症状的特异性见于口腔:12.9%的患者前庭后磨牙区出现硬化标记息肉样病变,9.7%的患者出现粘膜鹅卵石样病变,16.2%的患者出现弥漫性无症状颊肿胀,19.4%的患者出现粘膜炎。口腔非特异性病变更为常见:29.1%的患者患有牙根角炎,14.5%的患者患有萎缩性舌炎。口腔病变与血红蛋白、CRP浓度相关(r=-0.431、r=0.437;结论:成人活动性CD患者口腔黏膜变化频繁。它们应与乳糜泻患者胃肠道的其他临床症状和生化参数相关。这些变化的性质可能对进一步的治疗方法产生影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Oral mucosa lesions in patients with active Crohn’s disease - a prospective study.

Introduction: Crohn’s disease (CD) is a chronic inflammatory disease, which may involve any part of the gastrointestinal tract, including the oral cavity. Mucosal lesions in the oral cavity are described in various populations, but observations in active disease with severe clinical symptoms are quite rare.

Objectives: To evaluate the prevalence and nature of oral mucosa lesions in adult patients with active CD and their correlation with clinical and laboratory indicators of disease activity.

Material and methods: Prospective study was performed in 62 patients (29 women, 33 men, age 18-49 years) admitted between December 2010 and February 2013 to the gastroenterology department with a confirmed diagnosis of CD and exacerbations of symptoms, and 40 sex- and gender-matched healthy volunteers. CD activity was classified according to clinical and blood parameters, and the CD activity index (CDAI). We examined: blood morphology, hemoglobin and CRP levels, BMI. Examination of the oral cavity included a detailed interview and physical examination, based on the WHO recommendations.

Results: In patients with active CD we found: increased CDAI score (258.4±21.5), higher CRP levels (24.6±1.3 mg/l) and platelet count, anemia with significantly reduced RBC and hemoglobin level, and reduced BMI, in comparison to controls. The specific for CD symptoms were found in the mouth: indurated tag polypoid lesions on vestibular retromolar region in 12.9% of patients, cobblestoning of the mucosa in 9.7%, diffuse asymptomatic buccal swelling in 16.2%, mucogingivitis in 19.4% of patients. Oral nonspecific lesions were more frequent: angular cheilitis in 29.1%, atrophic glossitis in 14.5% of patients. Oral lesions correlated with hemoglobin and CRP concentrations (r=-0.431 and r=0.437; respectively; p<0.001), platelet count (r=0.45; p<0.003), CDAI (r=0.421; p<0.001) and BMI (r=0.307; p<0.006). No correlation has been found between specific or non-specific lesions and location of inflammatory changes in the gastrointestinal tract.

Conclusions: Changes in the oral mucosa in adult patients with active CD are frequent. They should be correlated with other clinical symptoms of gastrointestinal tract and biochemical parameters in patients with CD. The nature of these changes may have an impact on the further therapeutic approach.

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