酸刺激对腮腺和下颌下腺唾液流率及成分的影响

Effects of acid stimulation on saliva flow rate and compositions of human parotid and submandibular glands

目的:探讨酸刺激对腮腺和下颌下腺唾液流率及成分的影响,为全面评估健康和疾病状态时的唾液腺功能提供依据。方法:采用自然留取法收集210名健康志愿者在静息状态下的全唾液,负压吸引法收集腮腺、下颌下腺分泌液;2%柠檬酸每间隔1 min滴于舌尖进行酸刺激,共5次,收集酸刺激状态下全唾液、腮腺及下颌下腺分泌液,称量计算各项唾液流率。生化分析仪检测唾液样本的K^(+)、Na^(+)、Cl^(-)、Ca^(2+)、总蛋白、总磷浓度及α-淀粉酶水平,对比分析不同类别唾液流率及成分的变化特点。结果:与静息状态检测结果相比较,酸刺激后腮腺唾液流率增加的倍数(10.7倍)大于下颌下腺(2.9倍);腮腺唾液中的Na^(+)、Cl^(-)、Ca^(2+)、总蛋白和α-淀粉酶浓度明显升高(P<0.05),总磷、K^(+)差异无统计学意义(P=0.89,P=0.34);下颌下腺唾液中的Na^(+)和Ca^(2+)浓度显著升高(P<0.05),总磷浓度显著降低(P<0.05),Cl^(-)浓度升高,但差异无统计学意义(P=0.068),总蛋白、K^(+)和α-淀粉酶差异无统计学意义(P=0.85,P=0.07,P=0.95)。下颌下腺唾液中总磷的复合分泌速率不变(P=0.066),K^(+)、Na^(+)、Cl^(-)、Ca^(2+)、总蛋白、α-淀粉酶分泌速率升高(P<0.01)。腮腺唾液中K^(+)、Na^(+)、Cl^(-)、Ca^(2+)、总蛋白、总磷及α-淀粉酶的复合分泌速率均升高(P<0.01)。腮腺唾液中Na^(+)、Cl^(-)、K^(+)、总磷、总蛋白、α-淀粉酶浓度高于下颌下腺(P<0.01),下颌下腺唾液中Ca^(2+)浓度显著高于腮腺(P<0.001)。结论:腮腺对酸刺激的反应更为强烈,下颌下腺分泌较为稳定;酸刺激明显影响唾液中电解质的浓度,复合分泌速率是同时反映唾液流率和成分浓度的评价指标;腮腺在唾液总蛋白、总磷和α-淀粉酶的分泌过程中起重要作用,而下颌下腺是唾液中Ca^(2+)的主要来源。

Objective:To investigate the effect of acid stimulation on salivary flow rate and compositions of human parotid and submandibular glands,so as to provide basis for comprehensive evaluation of salivary gland function in both health and disease status.Methods:In the study,210 healthy participants’whole saliva samples were collected under passive drooling,and their parotid gland and submandibular gland secretions were collected by negative pressure suction.2%citric acid was dropped on the tip of tongue every 1 min for acid stimulation for a total of 5 times to collect stimulated whole saliva,parotid and submandibular gland saliva.The collected saliva was weighed and saliva flow rate was calculated.The K^(+),Na^(+),Cl^(-),Ca^(2+),total protein,total phosphorus andα-amylase in saliva samples were detected by biochemical analyzer,and the changing features of flow rate and compositions of different kinds of saliva were compared and analyzed.Results:After acid stimulation,saliva flow rate significantly increased.The increase proportion of parotid gland saliva(10.7 folds)was much higher than that of submandibular gland saliva(2.9 folds).The concentrations of Na^(+),Cl^(-),Ca^(2+),total protein andα-amylase in parotid gland saliva increased significantly(P<0.05),but there was no significant difference in total phosphorus and K^(+)(P=0.89,P=0.34).The concentration of Na^(+) and Ca^(2+) in saliva of submandibular gland increased significantly(P<0.05),the concentration of total phosphorus decreased significantly(P<0.05),and the concentration of Cl^(-) increased,but the difference was not significant(P=0.068).There was no significant difference in total protein,K^(+) and α-amylase(P=0.85,P=0.07,P=0.95).The compound secretion rate of total phosphorus in saliva of submandibular gland remained unchanged(P=0.066),while the secretion rate of K^(+),Na^(+),Cl^(-),Ca^(2+),total protein andα-amylase significantly increased(P<0.01).The compound secretion rate of K^(+),Na^(+),Cl^(-),Ca^(2+),total protein and total phosphorus andα-amylase in parotid gland saliva increased(P<0.01).The concentrations of Na^(+),Cl^(-),K^(+),total phosphorus,total protein andα-amylase in parotid were higher than those in submandibular gland(P<0.01),and the concentration of Ca^(2+) in submandibular gland saliva was significantly higher than that in parotid(P<0.001).Conclusion:The response of parotid to acid stimulation is stronger,and the secretion of submandibular gland is more stable.Acid stimulation significantly influences the concentrations of electrolytes in saliva,and the composited secretion rate is an evaluation index to reflect both flow rate and composition concentration of saliva.The parotid gland plays an important role in the secretion of total protein,total phosphorus andα-amylase in saliva,and the submandibular gland is the main source of Ca^(2+) in saliva.