CAJ | 학술논문

目的观察鼻咽癌(NPC)患者放疗前后牙菌斑中的变形链球菌、放线菌及放射性龋临床变化，以探讨放射性龋发生的机制。方法 22例NPC的患者在放疗前、放疗结束、放疗后3个月、6个月及1年取菌斑进行培养，观察可培养菌总数的构成比变化及记录变形链球菌数和放线菌数，并对患者出现的放射性龋临床症状进行定期观察和记录。结果 NPC患者放疗前牙菌斑与正常人牙菌斑细菌构成在统计学上无差异，NPC患者放疗前后牙菌斑的细菌构成比发生显著变化，重要致龋菌变形链球菌在放疗后占菌斑可培养细菌百分比随时间的推移而增加，放线菌则逐渐下降。临床上放疗早期口干、牙齿酸软症状发生率为100%，放疗后3个月可见牙齿脱钙、龋坏的现象，并随时间的推移，牙齿脱钙、龋坏现象日益明显，6个月到1年间形成典型的龋洞。结论放疗后口腔微生态环境的改变，特别是牙菌斑中细菌构成变化，是导致放射性龋发生的原因之一。
목적 관찰비인암(NPC)환자방료전후아균반중적변형련구균、방선균급방사성우림상변화，이탐토방사성우발생적궤제。방법 22례NPC적환자재방료전、방료결속、방료후3개월、6개월급1년취균반진행배양，관찰가배양균총수적구성비변화급기록변형련구균수화방선균수，병대환자출현적방사성우림상증상진행정기관찰화기록。결과 NPC환자방료전아균반여정상인아균반세균구성재통계학상무차이，NPC환자방료전후아균반적세균구성비발생현저변화，중요치우균변형련구균재방료후점균반가배양세균백분비수시간적추이이증가，방선균칙축점하강。림상상방료조기구간、아치산연증상발생솔위100%，방료후3개월가견아치탈개、우배적현상，병수시간적추이，아치탈개、우배현상일익명현，6개월도1년간형성전형적우동。결론 방료후구강미생태배경적개변，특별시아균반중세균구성변화，시도치방사성우발생적원인지일。
Objective To study the etiopathology of radiationcaries.Methods 22 patients with nasopharyngeal cancer (NPC) receiving radiotherapy were included in this study,samples of dental plaque were removed for culture of streptococcus mutans and actinomyces immediately before radiotherapy and after radiotherapy and at 3 mouths,6 mouths and 12 months after its termination.Cultural results were compared with those of 14 healthy people.Oral clinical changes were recorded during the study.Results The component percentage of bacteria was not different between patients before irradiated and healthy people.The component percentage of bacteria of plaque changed in patients after irradiation.Streptococcus mutans increased and Actinomyces decreased significantly step by step.The symptoms of xerostomia and tooth sensitivity were observed.The symptoms of calcipenia and caries were observed at 3 months after radiotherapy,which became worse with time.Conclusion The oral environment changes,especially the of component percentage of bacteria of plaque is one of the reasens for the occurrence of radiation caries.