精神分裂症患者口腔卫生状况调查回顾性研究

A retrospective study of oral health status in the schizophrenia patients

目的采用荟萃分析方法对精神分裂症患者口腔卫生状况调查的现有研究做系统性评价,以明确精神分裂患者口腔卫生的真实状况,为口腔临床预防保健与治疗提供理论基础。方法计算机检索从1997年1月至2017年6月收录在PubMed、EMBASE、Web of Science、PsycINFO、CNKI、万方、维普数据库上的精神分裂症患者口腔卫生相关的中英文文献,在质量评估和数据提取后,采用Revman5.3进行meta分析。结果本文共纳入9篇文献进行了meta分析(包括3840例精神分裂症患者、26094例正常对照)。精神分裂症患者人群的龋失补指数([mean difference MD]=7.24, 95%[confidence interval CI]=3.13～11.34)、失牙数(MD=7.61, 95%CI=3.44～11.77)、龋齿数(MD=3.44,95%CI=2.06～4.82)均高于对照组(P<0.01),补牙数(MD=-3.06, 95%CI=-4.82～-1.30)低于对照组(P<0.01)。结论精神分裂症患者口腔卫生状况较正常人群差,该类患者应成为口腔医疗服务的重点关注对象。

Objective Patients with schizophrenia have comorbid physical illness commonly. However, there is fewer data on dental disease in these patients. We systematically evaluated existing data on the oral health status survey of patients with schizophrenia through meta-analysis, which would provide a theoretical basis for clinical intervention treatment for dental disease in schizophrenia. Methods Using the databases of PubMed, EMBASE, Web of Science, PsyclNFO, CNKI, Wanfang and VIP, we performed a systematic search to identify studies examining the oral health in patients with schizophrenia from January 1997 to June 2017, based on the inclusion and exclusion criteria. Two investigators extracted the related data independently. The meta-analysis was performed by using the RevMan 5.3 software after data extraction and quality assessment. We compared the oral health results between the schizophrenia patients and the general population, including the following measures： the mean number of dental caries, missing, decayed, and filled teeth （DMFT）. Results 9 studies comprising 3840 patients with schizophrenia and 26094 normal controls were included in the meta-analysis. The patients with schizophrenia had significantly higher numbers of dental caries （mean difference[MD]=7.24; 95% confidence interval [CI]=3.13 to 11.34）, missing teeth （MD=7.61; 95% CI= 3.44 to 11.77）, and decayed teeth （MD=3.44; 95% CI=2.06 to 4.82） compared to controls. （all P〈0.01）. By contrast, the schizophrenia patients had fewer number of filled teeth （MD=-3.06; 95% CI=-4.82 to -1.30） than the controls （P〈0.01）. Conclusion Our systematic review suggests that patients with schizophrenia have worse oral health than the general population, but have received less dental care services. Hence, the oral health services should be administered increasingly in patients with schizophrenia.