口腔健康与抑郁症的关系研究

doi:10.12114/j.issn.1007-9572.2020.00.476

摘要/Abstract

摘要： 背景　抑郁症患者口腔健康状况不佳，唾液皮质醇可作为反映抑郁症患者精神压力的生物标志物，资料显示抑郁症患者唾液皮质醇水平升高，但抑郁症患者唾液皮质醇与口腔疾病的关系暂无明确结论。目的　通过测定唾液皮质醇水平，探讨口腔健康与抑郁症之间的关系。方法　以2018年11月—2019年5月就诊于石河子大学医学院第一附属医院心理科的抑郁症患者96例为抑郁症组；以同期于石河子大学医学院第一附属医院体检者96例为非抑郁症组。收集两组研究对象的混合唾液1 ml，通过酶联免疫吸附测定法测算标本中皮质醇水平，检查受试者口腔状况，使用口腔健康影响程度量表（OHIP-14）自测口腔健康状况对生活质量的影响。采用多因素Logistic回归分析抑郁症的影响因素。结果　抑郁症组口腔菌斑指数（PLI）、出血指数（BI）、牙周探诊深度（PD）、附着丧失（AL）、龋失补牙面数（DMFS）、龋病患病率、龋均、牙周病患病率、OHIP-14得分及唾液皮质醇水平高于非抑郁症组，差异有统计学意义（P<0.05）。抑郁症组和非抑郁症组女性唾液皮质醇水平均高于男性，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，控制龋病、牙周病及口腔健康影响程度后，唾液皮质醇水平和口腔健康影响程度是抑郁的影响因素（P<0.05）。相关性分析结果显示，抑郁症患者OHIP-14得分与PD、AL、BI和唾液皮质醇水平呈正相关（P<0.05）。结论　抑郁症可引起唾液皮质醇水平升高，导致口腔健康生存质量下降。抑郁症人群较非抑郁症人群更易于罹患龋病和牙周病。唾液皮质醇水平增高是抑郁的危险因素，同时也是抑郁症患者口腔疾病的危险因素。

关键词:
口腔健康, 抑郁症, 唾液皮质醇

Abstract:

Background　Patients with depression have poor oral health and salivary cortisol can be used as a biomarker reflecting mental stress of patients with depression. Data showed that salivary cortisol concentration increased in patients with depression，but the relationship between salivary cortisol and oral disease in patients with depression is not clear. Objective　To investigate the relationship between oral health and depression by measuring the concentration of salivary cortisol. Methods　A total of 96 patients with depression from the Department of Psychology in the First Affiliated Hospital of Shihezi University School of Medicine from November 2018 to May 2019 were selected as depression group；96 cases of physical examination in the First Affiliated Hospital of Shihezi University School of Medicine during the same period were selected as non-depression group. 1 ml of mixed saliva from the two groups of subjects was collected，the cortisol concentration in the specimens was measured by enzyme linked immunosorbent assay，the subject's oral condition was checked and the impact of oral health status to life quality was self-tested by Oral Health Impact Scale（OHIP-14）. Multivariate Logistic regression analysis was adopted to analyze the influencing factors of depression. Results　Oral plaque index（PLI），bleeding index（BI），periodontal probing depth（PD），attachent loss（AL），decay missing filling surface（DMFS），prevalence rate of dental caries，caries average，prevalence rate of periodontal disease，OHIP-14 score and concentration of salivary cortisol in the depression group were higher than those in the non-depression group，and the differences were statistically significant（P<0.05）. The females' concentration of salivary cortisol was higher than that of males both in the depression group and non-depression group，and the difference was statistically significant（P<0.05）. The results of multivariate Logistic regression analysis showed that after controlling the degree of caries，periodontal disease and oral condition，the concentration salivary and the degree of oral health impact were influencing factors for depression（P<0.05）. The results of correlation analysis showed that OHIP-14 score was positively correlated with PD，AL，BI and concentration of salivary cortisol in patients with depression（P<0.05）. Conclusion　Depression can increase the concentration of saliva cortisol，leading to a decline in oral health and quality of life. Depressed people are more likely to suffer from dental caries and periodontal disease than non-depressed people.Increased salivary cortisol concentration is a risk factor for both depression and oral disease in patients with depression.

Key words: Oral health, Depression, Saliva cortisol

韩亚茹,徐江,丁红忠. 口腔健康与抑郁症的关系研究[J]. 中国全科医学, 2021, 24(1): 75-79. DOI: 10.12114/j.issn.1007-9572.2020.00.476.
HAN Yaru,XU Jiang,DING Hongzhong. Correlation between Oral Health and Depression　[J]. Chinese General Practice, 2021, 24(1): 75-79. DOI: 10.12114/j.issn.1007-9572.2020.00.476.

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