口腔扁平苔藓患者心理因素与唾液脱氢表雄酮水平的关联性分析

doi:10.13481/j.1671-587x.20160119

摘要/Abstract

摘要：

目的: 分析口腔扁平苔藓(OLP)患者的焦虑、抑郁心理量表评分与唾液脱氢表雄酮(DHEA)水平的关系,阐明二者之间的关联性。方法: 对71例OLP患者 [其中充血糜烂型OLP(EOLP)患者31例,非EOLP患者40例]和31例对照组受试者采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评定,并在早晨采集唾液,采用放射免疫法测定唾液DHEA水平,分析各组受试者焦虑、抑郁心理量表评分与唾液DHEA水平的相关性。结果: EOLP组患者的HAMA评分和HAMD评分均明显高于对照组和非EOLP组(P<0.01),唾液DHEA浓度虽低于正常对照组,但差异无统计学意义 (P=0.054);非EOLP组患者的HAMA评分、 HAMD评分和唾液DHEA水平与对照组比较差异均无统计学意义(P>0.05)。EOLP组患者唾液DHEA水平与HAMA评分和HAMD评分呈负相关关系(r=-0.948,r=-0.966),非EOLP组患者的唾液DHEA水平与HAMA评分和HAMD评分亦呈负相关关系(r=-0.962,r=-0.971)。结论: EOLP的发生、发展与患者的焦虑、抑郁等情绪障碍有关,其作用机制可能与患者唾液DHEA水平的降低有关。

关键词: 口腔扁平苔藓, 焦虑, 抑郁, 唾液, 脱氢表雄酮

Abstract:

Objective: To explore the relationship between the scores of anxiety,depression and the salivary levels of dehydydroepiandrosterone(DHEA)in the patients with oral lichen planus (OLP),and to clarify the correlation between them. Methods: Thirty-one patients with erosive oral lichen planus (EOLP),40 patients with non-EOLP and 31 controls were investigated by the instruments Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD),respectively.The saliva of objects in various groups was collected in the morning for the determination of DHEA levels by radioimmunoassay to explore the relationship between the scores of anxiety,depression and the salivary levels of DHEA in various groups. Results: The scores of HAMA and HAMD of the patients in EOLP group were significantly higher than those in control group and non-EOLP group(P<0.01).The level of salivary DHEA of the patients in EOLP group was lower than that in control group,but there was no significant difference between two groups(P>0.05). There were no significant differences of the scores of HAMA HAMD and the levels of salivary DHEA of the objects between non-EOLP group and control group (P>0.05).The level of salivary DHEA of the patients in EOLP group was negatively correlated with their scores of HAMA(r=-0.948)and HAMD(r=-0.966 ).The level of salivary DHEA of the patients in non-EOLP group was also negatively correlated with their scores of HAMA(r=-0.962)and HAMD(r=-0.971).Conclusion: The occurrence and development of EOLP is related to anxiety and depression,and its mechanism may be related to the decrease of salivary DHEA level in the patients with EOLP.

Key words: oral lichen planus, anxiety, depression, salivary, dehydydroepiandrosterone

中图分类号:

R781.5

莫珩, 高承志, 王少杰. 口腔扁平苔藓患者心理因素与唾液脱氢表雄酮水平的关联性分析[J]. 吉林大学学报(医学版), 2016, 42(01): 94-98.

MO Heng, GAO Chengzhi, WANG Shaojie. Analysis on association between psychological factors and salivary DHEA level in patients with oral lichen planus[J]. Journal of Jilin University Medicine Edition, 2016, 42(01): 94-98.

参考文献

[1] 陈谦明.口腔黏膜病学[M].3版.北京:人民卫生出版社,2008:101-102.

[2] Adami GR,Yeung AC,Stucki G,et al.Gene expression based evidence of innate immune response activation in the epithelium with oral lichen planus[J].Arch Oral Biol,2014,59(3):354-361.

[3] Viguier M,Bachelez H,Poirier B,et al.Peripheral and local human papillomavirus 16-specific CD8⁺ T-cell expansions characterize erosive oral lichen planus[J].J Invest, Dermatol,2015,135(2):418-424.

[4] Valter K,Boras VV,Buljan D,et al.The influence of psychological state on oral lichen planus[J].Acta Clin Croat,2013,52(2):145-149.

[5] Gavic L,Cigic L,Biocina LD,et al.The role of anxiety,depression,and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus[J].J Oral Pathol Med,2014,43(6):410-417.

[6] Singh N,Zangmo R,Kumar S,et al.A prospective study on role of dehydroepiandrosterone (DHEA)on improving the ovarian reserve markers in infertile patients with poor ovarian reserve[J].Gynecol Endocrinol,2013,29(11):989-992.

[7] Girardi C,Luz C,Cherubini K,et al.Salivary cortisol and dehydroepiandrosterone (DHEA)levels,psychological factors in patients with oral lichen planus[J].Arch Oral Biol,2011,56(9): 864-868.

[8] Soto Arava M,Rojas Alcavaga G,Esguep A.Association between psychological disorders and the presence of oral lichen planus,burning mouth syndrome and recurrent aphthous stomatitis[J].Med Oral,2004,9(1):1-7.

[9] Thanakun S,Mtmikaankont P.Psychological profiles in a group of Thai patients with oral lichen planus[J].Mahidol Dent J,2006,26 (3):219-226.

[10] 林玲,唐国瑶.口腔扁平苔藓与情绪障碍的相关性研究[J].临床口腔医学杂志,2009,25(10): 622-625.

[11] Hirota SK,Moreno RA,Dos Santos CH,et al.Psychological profile (anxiety and depression)in patients with oral lichen planus: a controlled study[J].Minerva Stomatol,2013,62(3):51-56.

[12] Alshahrani S,Baccaglini L.Psychological screening test results for stress,depression,and anxiety are variably associated with clinical severity of recurrent aphthous stomatitis and oral lichen planus[J].J Evid Based Dent Pract,2014,14(4):206-208.

[13] Boscolo P,Youinou P,Theoharides TC,et al.Environmental and occupational stress and autoimmunity[J].Autoimmun Rev,2008,7(4):340-343.

[14] Elraiyah T,Sonbol MB,Wang Z,et al.Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA)in postmenopausal women with normal adrenal function: a systematic review and meta-analysis[J].J Clin Endocrinol Metab,2014,99(10):3536-3542.

[15] Hazeldine J,Arlt W,Lord JM.Dehydroepiandrosterone as a regulator of immune cell function[J].J Steroid Biochem Mol Biol,2010,120(2/3):127-136.

[16] Schmidt PJ,Daly RC,Bloch M,et al.Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression[J].Arch Gen Psychiatry,2005,62 (2): 154-162.

[17] Webb SJ,Geoghegan TE,Prough RA,et al.The biological actions of dehydroepiandrosterone involves multiple receptors[J].Drug Metab Rev,2006,38 (1/2): 89-116.

[18] Fernandes CS,Salum FG,Bandeira D,et al.Salivary dehydroepiandrosterone (DHEA)levels in patients with the complaint of burning mouth: a case-control study[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2009,108(4):537-543.