上海口腔医学

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (2): 189-192.doi: 10.19439/j.sjos.2022.02.014

• 论著 • 上一篇    下一篇

4种常用免疫抑制剂对器官移植术后口腔临床表现的影响

赵雯娇1,2, 金亚峰3, 吕柯佳1, 闫朵朵3, 姚华1   

  1. 1.浙江大学医学院附属第一医院 口腔科,浙江 杭州 310003;
    2.杭州市余杭区第二人民医院 口腔科,浙江 杭州 311121;
    3.浙江树人大学树兰国际医学院附属树兰杭州医院 口腔科,浙江 杭州 310022
  • 收稿日期:2020-07-27 修回日期:2021-10-22 出版日期:2022-04-25 发布日期:2022-05-16
  • 通讯作者: 姚华,E-mail: yaohua@zju.edu.cn
  • 作者简介:赵雯娇（1988-）,女,硕士,E-mail: y215180332@zju.edu.cn
  • 基金资助:
    浙江省医药卫生科技计划（2021PY007）; 浙江省中医药科技计划（2021ZA083）; 杭州市卫生计生科技计划一般项目（OO20190845）

The effect of four immunosuppressive drugs on oral manifestations after organ transplantation

ZHAO Wen-jiao1,2, JIN Ya-feng3, LYU Ke-jia1, YAN Duo-duo3, YAO Hua1   

  1. 1. Department of Stomatology, The First Affiliated Hospital, College of Medicine,Zhejiang University. Hangzhou 310003;
    2. Department of Stomatology, The Second People's Hospital of Yuhang District. Hangzhou 311121;
    3. Department of Stomatology, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College. Hangzhou 310022, Zhejiang Province, China
  • Received:2020-07-27 Revised:2021-10-22 Online:2022-04-25 Published:2022-05-16

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摘要： 目的： 通过观察分析肝、肾或造血干细胞移植术后口腔临床表现,探讨移植术后4种常用免疫抑制剂对口腔临床表现的影响。方法： 收集118例接受4种常用免疫抑制剂他克莫司、西罗莫司、环孢素或吗替麦考酚酯的实体器官或造血干细胞移植术后患者,采用问卷调查、口腔临床检查,记录患者术后口腔临床表现和免疫抑制剂的使用情况,并采用SPSS 21.0软件包对数据进行统计学分析。结果： 术后使用他克莫司的患者,口腔苔藓样病变和唇炎的发生率均显著低于未使用他克莫司组（P<0.01）;术后使用环孢素的患者,口腔苔藓样病变的发生率显著高于未使用环孢素组（P<0.05）,且唇炎的发生率显著高于未使用环孢素组（P<0.01）;术后使用他克莫司的患者,苔藓样病变、唇炎的发生率均显著低于使用环孢素组（P<0.01);术后使用吗替麦考酚酯的患者,自觉口干的发生率显著低于未使用吗替麦考酚酯组（P<0.01）;术后使用西罗莫司的患者,口腔临床表现发生率无明显降低。结论： 移植术后使用他克莫司,可改善口腔苔藓样病变和唇炎的症状,效果优于环孢素。使用吗替麦考酚酯可改善患者自觉口干症状。

关键词: 口腔苔藓样病变, 唇炎, 口干, 移植, 他克莫司, 环孢素, 吗替麦考酚酯

Abstract: PURPOSE: To assess the prevalence of oral manifestations in a group of allogenic liver, kidney or haematopoietic stem cell transplantation recipients and patients, and analyze the possible oral manifestations associated with the use of 4 immunosuppressive drugs. METHODS: One hundred and eighteen patients submitted to liver, kidney and hematopoietic stem cell transplantation who used tacrolimus, sirolimus,cyclosporine or mycophenolate mofetil were enrolled. Through a questionnaire survey and oral examination, their oral manifestations were recorded, and the possible statistical associations with immunosuppressive drugs were analyzed using SPSS 21.0 software package. RESULTS: The prevalence of oral lichenoid lesions and cheilitis for the group of patients using tacrolimus after transplantation was significantly lower than the group of patients who did not used the agent(P<0.01). The prevalence of oral lichenoid lesions for the group of patients who used cyclosporine was significantly higher than the group of patients who did not used the drug(P<0.05), and the prevalence of cheilitis for the group of patients who used cyclosporine was significantly higher than the group of patients who did not used the drug(P<0.01). The prevalence of oral lichenoid lesions and cheilitis for the group of patients who used tacrolimus was significantly lower than the group of patients who used cyclosporine(P<0.01). The group of patients who used mycophenolate mofetil after transplantation had a significantly lower prevalence of dry mouth than the group of patients who did not used the drug(P<0.01). The prevalence of oral manifestations in patients with sirolimus after transplantation was not significantly reduced. CONCLUSIONS: The use of tacrolimus improved the symptoms of oral lichenoid lesions and cheilitis and the effect was better than cyclosporine after transplantation. The use of mycophenolate mofetil improved dry mouth after organ transplantation.

Key words: Oral lichenoid lesions, Cheilitis, Dry mouth, Organ transplantation, Tacrolimus, Cyclosporine, Mycophenolate mofetil

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