口腔扁平苔藓与情绪障碍的相关性研究

The study of the association between oral lichen planus and the mood obstacle

目的:探讨口腔扁平苔藓(OLP)症状、体征的严重程度与焦虑、抑郁、生活事件水平以及血清皮质醇(COR)、甲状腺激素(FT3、FT4、TSH)水平的关系。方法:采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、生活事件量表(LES)对56例OLP患者(白纹组39例,糜烂组17例)进行评定;同时空腹抽静脉血测定血清COR、FT3、FT4、TSH水平。结果:糜烂组和白纹组SAS、SDS、HAMA、HAMD、LES测定值均数与正常人相比无统计学差异;两组患者的SAS、SDS、HAMA、HAMD、LES、COR、FT3、FT4和TSH测定值之间均无统计学差异;糜烂型OLP病例中,焦虑组的TSH值明显高于非焦虑组,应激组的COR值明显高于非应激组,其差异均存在统计学意义(P<0.05);OLP患者的总生活事件刺激量及负性生活事件刺激量与SAS、SDS、HAMA、HAMD分值呈正相关,未发现OLP患者的血清皮质醇、甲状腺激素水平、焦虑、抑郁等情绪障碍、生活事件水平与其症状、体征之间有其他相关关系。结论:虽然不能认为OLP发生、发展与焦虑、抑郁等情绪障碍有关,但是OLP患者焦虑、抑郁症状的严重程度与总生活事件水平及负性生活事件水平呈正相关;情绪障碍在糜烂型OLP发生、发展中的作用机制可能与应激反应有关。

Objective： To determine the relationship of symptoms and signs of oral lichen planus （OLP）, the levels of anxiety, depression and life events and COR,FT3,FT4,TSH. Method：56 OLP patients （39 patients with reticular; 17 with erosive form of OLP） were tested with the SAS, SDS,HAMA,HAMD, LES as well as con, FT3, FT4,TSH level.Result： The scores of the SAS,SDS,HAMA,HAMD,LES in two OLP groups were not different from which in normal people.No statistical differences between two groups were detected for the scores of SAS,SDS,HAMA,HAMD,LES and the mean levels of serum eortisol,TSH,FT3,FT4.Among the patients with erosive form of OLP, the TSH levels in group with anxiety were remarkably higher than those in group without anxiety, the con levels in group with stress were remarkably higher than those in group without stress. Except the total and negative life event level were positively correlated to their scores of SAS,SDS,HAMA,HAMD in the OLP patients, no other correlation was detected among serum cortisol,TSH,FT3,gl＇4, scores of SAS,SDS,HAMA,HAMD,LES and their symptoms,constitutions value. Conclusion：The association between pathogenesis and exacerbation of OLP and the mood obstacle can not be infered in the present study,but the degree of depression and anxiety in the OLP patients are positively correlated to the total and negative life event levels; Psychological status may play important role in the pathogenesis and exacerbation of erosive forms of OLP by means of psychosomatic response to stress.