江苏省一般人群口腔扁平苔藓的临床特征及危险因素

目的：探讨江苏省一般人群口腔扁平苔藓（oral lichen planus，OLP）的临床特征及相关的危险因素，为OLP的诊断和预防提供理论依据。方法：采用病例对照的研究设计，在2017年1月—2018年6月于南京医科大学附属口腔医院纳入177例OLP患者为病例组，同时于体检中心招募207例健康体检者为对照组。收集所有研究对象的流行病学资料并对其进行口腔检查。逐步Logistic回归分析OLP的相关危险因素。结果：177例OLP患者中，36.72%（65/177）为糜烂型，颊黏膜（86.44%，153/177）是最主要的累及部位，最常见的症状为进食辛辣食物疼痛感（77.84%，137/176）。逐步Logistic回归分析结果显示，既往伤心事史（OR=2.81，95%CI：1.30~6.04）、失眠（OR=3.49，95%CI：1.56~7.79）、内分泌/代谢紊乱（OR=3.27，95%CI：1.22~8.80）和牙齿尖锐边缘（OR=56.04，95%CI：6.16~509.65）是OLP发生的独立危险因素，高学历是OLP的保护因素（高中：OR=0.42，95%CI：0.18~0.99；大专及以上：OR=0.08，95%CI：0.03~0.18）。结论：OLP最主要的累及部位是颊黏膜，最常见的症状为进食辛辣食物疼痛感。应重点监测失眠患者、内分泌/代谢紊乱患者、受教育程度较低人群和具有牙齿尖锐边缘人群的OLP患病情况。

Clinical characteristics and risk factors of oral lichen planus in the general population of Jiangsu province

Objective: To investigate the clinical characteristics and risk factors of oral lichen planus (OLP) in the general population of Jiangsu province, and to provide a theoretical basis for the diagnosis and prevention of OLP. Methods: In this study, a case-control study design was used. Between January 2017 and June 2018, 177 patients with OLP were enrolled in the Affiliated Stomatological Hospital of Nanjing Medical University, and 207 healthy subjects were recruited at the physical examination center. Chi-square test and Stepwise logistic regression analysis were used for analysis. Results: Of the 177 OLP patients enrolled in the study, 36.72% (65/177) of the erosive OLP and buccal mucosa (86.44%, 153/177) were the most important sites of involvement. The most common symptom is the consumption of spicy food (137/176, 77.84%). Stepwise logistic regression analysis showed previous history of sadness (OR=2.81, 95% CI=1.30-6.04), insomnia (OR=3.49, 95% CI=1.56-6.04), endocrine/metabolic disorder (OR=3.27, 95%CI=1.22-8.80) and sharp edges of the teeth (OR=56.04, 95% CI=6.16-509.65) were independent risk factors for OLP, and high education was a protective factor for OLP (high school: OR=0.42, 95% CI= 0.18-0.99; college and above: OR=0.08, 95% CI=0.03-0.18). Conclusion: The most common site of damage to OLP was the buccal mucosa and the most common symptom was the pain of eating spicy food. More attention should be paid to the prevalence of OLP in patients with insomnia, endocrine/metabolic disorder, people with lower education levels, and people with sharp edges of teeth.