抗精神病药物对龋齿发生的危险因素的影响分析

目的比较长期服用抗精神病药的住院精神分裂症患者(简称服药人群)和健康人群的龋齿发生因素如唾液氟离子浓度(F-浓度)、唾液流速以及唾液p H值的差异,研究服药人群龋病高发的主要影响因素,探讨早期干预龋病的措施。方法采用病例对照的研究方法,服药组80例为2012年5月-2013年10月在上海市杨浦区精神卫生中心住院的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的精神分裂症患者,对照组40例为普通健康人群。收集并测定其唾液F-浓度、流速以及p H值。运用独立样本t检验,非参数检验Spearman相关分析进行分析。结果 1服药组唾液F-浓度(1.86±2.23)mmol/L低于对照组(4.40±6.27)mmol/L;服药组唾液流速(1.46±0.97)ml/min低于对照组(1.99±0.51)ml/min;服药组p H值(6.30±0.39)低于对照组(7.09±0.34),差异均有统计学意义(P均0.05)。2服药组和对照组唾液之流速和p H值均呈正相关(r=0.459,P0.05);服药组和对照组唾液流速和F-浓度呈负相关(r=-0.415,P0.05);唾液p H值和F-浓度呈负相关(r=-0.496,P0.05)。结论服药人群中较低的唾液F-浓度、唾液流速以及唾液p H值可能是该人群龋齿高发的主要影响因素,其中唾液流速与F-浓度是需重点干预的环节。

Study about the effect of antipsychotics on the factors causing dental caries

Objective To compare saliva fluorinion concentration,saliva flow velocity and saliva pH value between hospitalized schizophrenics and general population. To explore the main influential factors that cause the high incidence of dental caries in schizo-phrenics patients,and the early interventional measures for dental caries. Methods In this case-control study,we collected the sali-va of 80 medicated schizophrenics inpatients and 40 healthy persons. The inpatients diagnosed as schizophrenia according to ICD-10 when treated in Shanghai Yangpu District Mental Health Center. We tested their saliva fluorinion concentration,saliva flow velocity and saliva pH value. The results were analyzed by using independent-Samples t-test and non-parameter test Spearman correlation anal-ysis. Results ①The fluorinion concentration of inpatients（1. 86 ± 2. 23）mmol/L was significantly lower than healthy controls（4. 40 ± 6. 27）mmol/L,saliva flow velocity of inpatients（1. 46 ± 0. 97）ml/min was significantly lower than healthy controls（1. 99 ± 0. 51）ml/min,and the saliva pH value of inpatients（6. 30 ± 0. 39）were significantly lower than healthy controls（7. 09 ± 0. 34）（P﹤0. 05）. ②The saliva flow velocity and pH of both group were positive correlated（r=0. 459,P﹤0. 05）. The saliva flow velocity was negative correlated with the fluorinion concentration（r= -0. 415,P﹤0. 05）and saliva pH（r= -0. 496,P﹤0. 05）in both inpa-tients group and healthy control group. Conclusion The significantly lower saliva fluoride concentration,saliva flow velocity and saliva pH value may have contributed to the high incidence of dental caries among the patients taking antipsychotics. Interventions on these factors,especially on saliva flow velocity and saliva pH,should be taken to decrease the high incidence of dental caries among patients taking antipsychotics.