口腔扁平苔藓合并2型糖尿病的临床及病理特征研究

Clinical and histopathological characteristics of oral lichen planus patients with type 2 diabetes mellitus

目的 通过病例对照研究分析口腔扁平苔藓(oral lichen planus, OLP)合并2型糖尿病(type 2 diabetes mellitus, T2DM)的临床及组织病理学表现特征。方法 将104例患者分为OLP组与OLP+T2DM组。收集患者的基本信息,OLP的临床类型与REU评分,两位病理专家对组织病理表现进行具体描述。应用SPSS 24.0对两组间的临床与组织病理表现进行统计分析。结果 OLP+T2DM组糜烂型OLP的发生率与REU评分均显著高于OLP组(P<0.001)。随访1个月后,服用降糖药物(P<0.001)和血糖控制理想(P<0.01)的OLP患者REU评分均显著降低。多因素二元Logistic回归分析显示:高REU评分、糜烂型、淋巴细胞浸润密集、淋巴浸润带不清晰、基底层重度炎症、基底层纤维蛋白的存在(OR=1.58、37.15、8.49、10.16、3.94、4.35)是OLP合并T2DM的典型特征。结论 合并T2DM的OLP患者临床病损更严重,组织破坏程度更高,临床诊治应制定个性化方案,以获得精准治疗效果。

Objective To analyze the clinical and histopathological characteristics of oral lichen planus(OLP) complicated with type 2 diabetes mellitus(T2 DM) through case-control study. Methods One hundred and four patients were divided into OLP group and OLP+T2 DM group and their basic information, clinical types and REU scores of OLP were collected. Histopathological manifestations were described by two pathologists. Clinical and histopathological manifestations between the two groups were analyzed by SPSS 24.0. Results The prevalence of erosive OLP and REU score in OLP+T2 DM group were significantly higher than those in OLP group(P<0.001). After one month follow-up, REU score of OLP patients taking hypoglycemic drugs decreased significantly(P<0.001), and that of OLP patients with ideal blood glucose control(P<0.01) decreased significantly. Logistic regression analysis showed that: high REU score, erosion type, dense lymphocyte infiltration, unclear lymphocyte infiltration zone, severe inflammation in the basal layer, and presence of fibrin in the basal layer(OR=1.58, 37.15, 8.49, 10.16, 3.94, 4.35) were typical characteristics of OLP with T2 DM. Conclusion OLP patients with T2 DM have more severe clinical lesions and higher degree of tissue destruction. A personalized plan should be made to obtain better treatment effect.