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新冠病毒感染患者口腔临床表现特点调查及危险因素分析

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目的 调查新型冠状病毒(新冠病毒)感染患者口腔临床表现的特点及口腔临床表现改变的危险因素。方法 选择 2022 年 12 月至 2023 年 6 月在首都医科大学附属北京友谊医院就诊的 649 例新冠病毒感染患者,根据年龄分为青年(年龄为 18~40 岁)组、中年(年龄为 41~65 岁)组和老年(年龄为 65 岁以上)组,调查分析其感染新冠病毒过程中口腔临床表现改变特点及相关危险因素。结果 649 例新冠病毒感染者中,男 231 例、女 418 例,年龄为(42。69±12。55)岁。除牙齿松动外的其他口腔临床表现发生率在阳性期与转阴期比较差异均有统计学意义(P均<0。05)。按年龄分组后,阳性期中,味觉障碍(青年组vs。老年组,中年组vs。老年组)、牙髓炎/根尖炎(青年组vs。中年组)、牙龈肿痛(中年组vs。老年组)、牙龈痒胀(青年组vs。老年组)、口干(中年组vs。老年组,青年组vs。老年组)、口腔溃疡(中年组vs。老年组,青年组vs。老年组)比较差异均有统计学意义(P均<0。017)。转阴期中,牙龈肿痛(青年组vs。中年组,青年组vs。老年组)、口干(中年组vs。老年组、青年组vs。老年组)、口腔溃疡(中年组vs。老年组)比较差异均有统计学意义(P均<0。017)。按性别分组后,阳性期中,女性感染者味觉障碍、口干的发生率高于男性(P<0。05),而男性感染者舌体不适的发生率高于女性感染者(P<0。05);转阴期中,男性患者与女性患者仅有味觉异常比较差异有统计学意义(P<0。05),其余口腔特征的发生率比较差异均无统计学意义(P均>0。05)。单因素及多因素Logistic回归分析均显示,女性及高血压均为新冠病毒感染患者口腔临床表现改变的危险因素(P均<0。05)。新冠病毒感染期间患者服用的药物与口腔临床表现改变无关(P均>0。05)。结论 在感染的不同阶段,新冠病毒感染患者的口腔临床表现可能存在差异,这些差异可能与患者的性别、年龄等因素相关。临床工作中应特别关注新冠病毒感染对患者口腔健康的影响。对于存在高危因素(如女性和高血压患者)的个体,应加强口腔卫生教育,提供针对性的预防措施和指导,以维持和改善他们的口腔健康状况。
Oral clinical manifestation and risk factors of COVID-19 infected patients
Objective To investigate the characteristics of oral clinical manifestation and risk factors of patients infected with novel corona virus(COVID-19).Methods A total of 649 COVID-19 patients admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from December 2022 to June 2023 were enrolled.All patients were divided into the young(18-40 years),middle-aged(41-65 years)and elderly groups(>65 years)according to age.The changes in oral clinical manifestation and related risk factors during COVID-19 infection were investigated and analyzed.Results Among 649 infected patients,231 were male and 418 were female,with an average age of(42.69±12.55)years.Except loose teeth,the differences were statistically significant in the incidence of other oral clinical manifestation during the positive and negative periods(all P<0.05).After age grouping,there were significant differences in the incidence of taste disorder(young group vs.elderly group,middle-aged group vs.elderly group),pulpitis/apical periodontitis(young group vs.middle-aged group),gingival swelling and pain(middle-aged group vs.elderly group),gingival itching and swelling(middle-aged group vs.elderly group),dry mouth(middle-aged group vs.elderly group,young group vs.elderly group),and oral ulcers(middle-aged group vs.elderly group,young group vs.elderly group)during the positive period(all P<0.017).During the period of negative conversion,there were significant differences in the incidence of gingival swelling and pain(young group vs.middle-aged group,young group vs.elderly group),dry mouth(middle-aged group vs.elderly group,young group vs.elderly group),and oral ulcers(middle-aged group vs.elderly group)(all P<0.017).After gender grouping,in the positive period,the incidence of taste disorder and dry mouth in the female patients was significantly higher than that of male counterparts(both P<0.05),whereas the incidence of tongue discomfort in male patients was significantly higher compared with that of female patients(P<0.05).During the negative conversion period,there was a significant difference in the incidence of taste disorder between two genders(P<0.05),and the incidence of other oral manifestation did not significantly differ between two genders(all P>0.05).Univariate and multivariate Logistic regression analyses showed that both female gender and hypertension were the risk factors for the changes of oral clinical manifestation in COVID-19 patients(both P<0.05).The drugs taken by patients during COVID-19 infection were not associated with the changes of oral clinical manifestation(all P>0.05).Conclusions Oral clinical manifestation probably differ during different stages of COVID-19 infection,which might be associated with gender and age,etc.Extensive attention should be paid to oral hygiene of COVID-19 patients.For patients with high risk factors(female gender and hypertension),oral hygiene education should be strengthened and specific preventive measures and guidance should be delivered,aiming to maintain and improve their oral hygiene conditions.

Novel corona virusOral clinical manifestationMucosal lesionGingival changeDental change

郭婧芳、王慧、黄晓峰、王欢欢

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首都医科大学附属北京友谊医院口腔科,北京 100050

新型冠状病毒 口腔临床表现 黏膜病变 牙龈改变 牙体改变

2024

新医学
中山大学

新医学

CSTPCD
影响因子:0.8
ISSN:0253-9802
年,卷(期):2024.55(11)