血友病患者口腔健康状况的影响因素分析

Oral Health of Patients with Hemophilia: A Multivariate Analysis

目的了解血友病患者口腔健康状况并探讨其相关影响因素。方法 2011年2月—2012年9月,对179例血友病患者进行口腔保健知识及行为的问卷调查,并由牙周病专业医生对患者进行口腔检查,包括菌斑指数、牙石指数、出血指数及龋失补指数等口腔健康状况指标。采用多因素分析建回归模型的方法,分析血友病患者口腔健康状况的影响因素。结果口腔保健行为问卷得分及牙石指数与菌斑指数显著相关(P<0.05);患者的年龄、龋失补指数、自发牙龈出血、出血指数和菌斑指数与牙石指数显著相关(P<0.05);年龄、凝血因子含量、菌斑指数、龋失补指数和牙石指数与出血指数显著相关(P<0.05);日常吃软物出血、牙石指数、医保分类与龋失补指数显著相关(P<0.05)。结论口腔保健行为是血友病患者口腔健康程度的重要影响因素,菌斑的发生进一步影响牙石的产生,又进行性发展为牙龈出血,吃软物出血则是患者高发龋失补的重要标志。

Objective To explore factors correlating with oral health of hemophiliac. Methods From Feb. 2011 to Sept. 2012, oral health knowledge and behaviors in patients with severe hemophilia were surveyed by questionnaire at hemophilia treatment center of Peking Union Medical College Hospital, and oral examinations were performed by periodontists. Oral health evaluation indexes including dental plaque index, calculus index, bleeding index and decayed, missing and filled teeth （DMFT） indexes were recorded. Results Both the behavior questionnaire score and calculus index were significantly correlated with plaque index （ P〈0.05） and patient’s age and education, and plaque index were significantly correlated with calculus index （P〈0.05）. Both the behavior questionnaire score and calculus index were significantly correlated with bleeding index （ P〈0.05） and bleeding during eating soft food was significantly correlated with DMFT （P〈0.05）. Conclusion Oral health behavior is an important factor affecting oral health of hemophiliacs. The occurrence of dental plaques can affect the generation of calculus, which further develops progressively into gingival bleeding. Bleeding during eating soft food is an important sign of high incidence of DMFT （decaying, missing and filling of teeth）.