血液透析患者龋病和牙周健康状况的系统评价

摘要

目的 对接受维持性血液透析的终末期肾病患者的龋病和牙周健康状况进行系统评价.方法 计算机检索中国学术期刊全文数据库(CNKI)、万方数据库、PubMed、Web of Science、Cochrane Library数据库,收集国内外公开发表的研究血液透析患者口腔健康状况的病例对照和横断面研究,检索时间截止2016年5月.由2名研究者根据纳入与排除标准对相关文献进行筛选,并对文献进行质量评价和提取数据,对同质研究采用Revman 5.3软件进行Meta分析.结果 研究最终纳入16篇文献,Meta分析结果显示,血液透析患者人群的牙菌斑指数(MD=0.62,95%CI为0.51~0.72)、牙石指数(MD=1.09,95%CI为0.56~1.63)、牙周袋深度(MD=0.63,95%CI为0.29~0.98)、附着丧失(MD=0.63,95%CI为0.56~0.69)均高于对照组(P<0.01),而龋失补牙数(MD=1.12,95%CI为-1.08~3.32)与对照组无统计学差异(P=0.32).结论 行血液透析治疗的终末期肾病患者的龋病状况与健康对照人群无明显差异,但口腔卫生和牙周状况较差,在临床治疗时需得到重视.%Objective This study aimed to systematically evaluate the oral health status of patients suffering from chronic renal failure and undergoing hemodialysis (HD).Methods Electronic databases, namely, China National Knowledge Infras-tructure, Wanfang Data base, PubMed, Web of Science, and Cochrane Library, were searched until May 2016 for cross-sectional and case-control studies that investigated the oral health status of patients suffering from chronic renal failure and undergoing HD. Two reviewers independently screened the trials, extracted the data, assessed the quality, and conducted a Meta-analysis with RevMan 5.3 in accordance with the inclusion and exclusion criteria.Results Sixteen studies satisfied the eligibility criteria. Meta-analysis revealed that plaque index (MD=0.62, 95%CI: 0.51-0.72), calculus index (MD=1.09, 95%CI: 0.56-1.63), probing depth (MD=0.63, 95%CI: 0.29-0.98), and attachment loss (MD=0.63, 95%CI: 0.56-0.69) were significantly higher in the patients undergoing HD than in the healthy control group (P<0.01). No significant differences in decayed missing filled teeth (MD=1.12, 95%CI:-1.08-3.32) were observed between the patients undergoing HD and the healthy control group (P=0.32).Conclusion The prevalence of caries in patients undergoing HD is similar to that in the healthy control group. However, these patients are at a higher risk of acquiring periodontal diseases than the healthy control group. Thus, the oral health status of these patients should be further evaluated in clinical treatments.