Association between dental infections and the clinical course of chronic liver disease
Association between dental infections and the clinical course of chronic liver disease
复制标题
DOI：
10.1111/hepr.12126
复制
发表时间：
2014-03-01
影响因子：
4.2
通讯作者：
Isoniemi, Helena
中科院分区：
文献类型：
--
作者：
Aberg, Fredrik;Helenius-Hietala, Jaana;Isoniemi, Helena
由于菌血症和促炎作用，口腔感染与几种全身性疾病有关，但它们在肝脏疾病中的可能作用尚不清楚。方法回顾性分析116例肝硬化患者肝移植前行口腔检查的肝病临床病程与口腔健康的关系。结果需要多次拔牙（牙齿感染的替代标志物）与从肝病诊断到需要肝移植的时间缩短相关（P = 0.02）。相关性与年龄、性别、肝病病因和终末期肝病模型（MELD）评分无关（P = 0.04）。在38例实验室随访数据准确的患者中，拔牙次数与牙齿检查前一年MELD评分变化相关（r = 0.43, P = 0.03）。由翠绿链球菌引起的自发性细菌性腹膜炎仅发生在多次牙齿感染的患者中。结论口腔感染可能影响肝病的临床病程，但仍需进行前瞻性研究。
AimDental infections are implicated in several systemic diseases due to bacteremia and pro-inflammatory effects, but their possible role in liver disease is unclear.MethodsWe retrospectively analyzed the clinical course of liver disease in relation to dental health among 116 patients with liver cirrhosis who underwent dental examination before liver transplantation.ResultsThe need for multiple tooth extractions, a surrogate marker of dental infections, was associated with reduced time from diagnosis of liver disease to the need for liver transplantation (P = 0.02). The association was independent of age, sex, liver disease etiology and Model for End-Stage Liver Disease (MELD) score (P = 0.04). Among 38 patients with accurate laboratory follow-up data, the number of tooth extractions correlated with the change in MELD score during the year preceding dental examination (r = 0.43, P = 0.03). Spontaneous bacterial peritonitis caused by Streptococcus viridans occurred only among patients with multiple dental infections.ConclusionDental infections may influence the clinical course of liver disease, but prospective studies are needed.