CAJ | 학술논문

目的：探讨口腔扁平苔藓（OLP）患者情绪障碍与唾液皮质醇和脱氢表雄酮（DHEA）水平的相关性。方法：采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评定非糜烂型OLP组（40例）、糜烂型OLP组（31例）和对照组（31例）的焦虑、抑郁状况，并在早晨采集唾液，通过放射免疫法对受试者的唾液皮质醇和DHEA水平进行测定，分析量表得分与唾液皮质醇和DHEA水平的相关性。结果：3组受试者的HAMA得分、HAMD得分、唾液皮质醇水平差异均有统计学意义（F＝15．892、4．876和14．375，P＜0．05），糜烂型OLP组HAMA得分、HAMD得分、唾液皮质醇水平均高于对照组和非糜烂型OLP组（P＜0．05）。糜烂型OLP组唾液皮质醇水平与HAMA得分和HAMD得分（r＝0．965、0．923，P ＜0．001）呈正相关，而唾液 DHEA 水平与 HAMA 得分和 HAMD 得分（r ＝－0．948、－0．966，P＜0．001）呈负相关。非糜烂型 OLP组唾液皮质醇水平与 HAMA 得分和HAMD 得分（r ＝0．963、0．957，P＜0．001）呈正相关，而唾液DHEA水平与HAMA得分和HAMD得分（ r＝－0．962、－0．971，P＜0．001）呈负相关。结论：糜烂型OLP的发生、发展与焦虑、抑郁等情绪障碍有关，其作用机制可能是通过应激反应导致糜烂型OLP患者的唾液皮质醇水平升高，但是否与唾液DHEA水平的降低相关还有待进一步的研究。
목적：탐토구강편평태선（OLP）환자정서장애여타액피질순화탈경표웅동（DHEA）수평적상관성。방법：채용한밀이돈초필량표（HAMA）、한밀이돈억욱량표（HAMD）평정비미란형OLP조（40례）、미란형OLP조（31례）화대조조（31례）적초필、억욱상황，병재조신채집타액，통과방사면역법대수시자적타액피질순화DHEA수평진행측정，분석량표득분여타액피질순화DHEA수평적상관성。결과：3조수시자적HAMA득분、HAMD득분、타액피질순수평차이균유통계학의의（F＝15．892、4．876화14．375，P＜0．05），미란형OLP조HAMA득분、HAMD득분、타액피질순수평균고우대조조화비미란형OLP조（P＜0．05）。미란형OLP조타액피질순수평여HAMA득분화HAMD득분（r＝0．965、0．923，P ＜0．001）정정상관，이타액 DHEA 수평여 HAMA 득분화 HAMD 득분（r ＝－0．948、－0．966，P＜0．001）정부상관。비미란형 OLP조타액피질순수평여 HAMA 득분화HAMD 득분（r ＝0．963、0．957，P＜0．001）정정상관，이타액DHEA수평여HAMA득분화HAMD득분（ r＝－0．962、－0．971，P＜0．001）정부상관。결론：미란형OLP적발생、발전여초필、억욱등정서장애유관，기작용궤제가능시통과응격반응도치미란형OLP환자적타액피질순수평승고，단시부여타액DHEA수평적강저상관환유대진일보적연구。
Aim:To explore the relationship between scores of anxiety , depression and the salivary levels of cortisol , DHEA in patients with oral lichen planus ( OLP) .Methods:Thirty-one patients with erosive oral lichen planus ( EOLP) ,40 patients with non-EOLP and 31 control patients were investigated by the instruments Hamilton Anxiety Scale and Hamilton Depression Scale , respectively .Saliva was collected in the morning for the determination of cortisol , DHEA levels by radio-immunoassay to explore the relationship between scores of anxiety , depression and the salivary levels of cortisol , DHEA in the three groups .Results:There were significant differences in the scores of HAMA , HAMD and the concentration of sali-vary cortisol of objects in three groups (F=15.892,4.876 and 14.375,P<0.05).Compared with controls and patients with non-EOLP, the scores of HAMA , HAMD and the concentration of salivary cortisol in patients with EOLP were signifi-cantly higher(P<0.05).In addition, the concentration of salivary cortisol in patients with EOLP was positively correlated with their scores of HAMA(r =0.965,P<0.001) and HAMD (r =0.923,P<0.001).The concentration of salivary DHEA in patients with EOLP was negatively correlated with their scores of HAMA ( r=-0.948,P<0.001) and HAMD (r=-0.966,P<0.001).The concentration of salivary cortisol in patients with non-EOLP was positively correlated with their cores of HAMA (r=0.963,P<0.001) and HAMD (r=0.957,P<0.001).The concentration of salivary DHEA in patients with non-EOLP was negatively correlated with their scores of HAMA ( r =-0.962, P <0.001 ) and HAMD (r=-0.971,P<0.001).Conclusion:The pathogenesis and exacerbation of EOLP could be inferred by the mood obsta-cle.Anxiety and depression may result in higher concentration of salivary cortisol in patients with EOLP by means of psy -chosomatic response to stress .While the relation between anxiety , depression and lower salivary DHEA levels in patients with EOLP remains unclear and more research is needed in future .