口腔溃疡凝胶联合曲安奈德对口腔黏膜下纤维性变患者炎症因子、肿瘤标志物及血液流变学的影响

Effects of oral ulcer gel combined with Triamcinolone on inflammatory factors, tumor markers and hemorheology in patients with oral submucosal fibrosis

摘要:

目的 研究口腔溃疡凝胶联合曲安奈德对口腔黏膜下纤维性变（OSF）患者炎症因子、肿瘤标志物及血液流变学的影响。方法 选择2019年7月—2022年6月于合肥市第二人民医院治疗的OSF患者94例，按随机数字表法分为联合组与对照组，每组47例。对照组行曲安奈德治疗，联合组行口腔溃疡凝胶联合曲安奈德治疗。比较两组治疗前后张口度、黏膜病损面积、疼痛等临床指标。比较两组血清白细胞介素-2（IL-2）、转化生长因子-β₁（TGF-β₁）、肿瘤坏死因子-α（TNF-α）等炎症因子水平。比较两组血清神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（Cyfra21-1）、鳞状细胞癌抗原（SCC-Ag）等肿瘤标志物水平。比较两组全血黏度低切（LS）、血浆黏度（PV）及纤维蛋白原（Fib）等血液流变学指标。比较两组不良反应发生情况。结果 联合组治疗前后张口度、黏膜病损面积和VAS评分的变化程度均大于对照组（P <0.05）。联合组治疗前后血清IL-2、TGF-β₁、TNF-α、NSE、Cyfra21-1、SCC-Ag的下降幅度均大于对照组（P <0.05）。联合组治疗前后LS、PV、Fib的下降幅度均大于对照组（P <0.05）。联合组治疗总有效率高于对照组（P <0.05）。治疗期间，两组均无显著不良反应。结论 口腔溃疡凝胶联合曲安奈德治疗OSF疗效好，可降低血清炎症因子、肿瘤标志物水平，并改善血液流变学，无显著不良反应。

关键词:口腔黏膜下纤维性变;口腔溃疡凝胶;曲安奈德;炎症因子;肿瘤标志物;血液流变学

Abstract:

Objective To investigate the effects of oral ulcer gel combined with triamcinolone on inflammatory factors, tumor markers and hemorheology in patients with oral submucosal fibrosis (OSF).Methods A total of 94 patients with OSF treated in our hospital from July 2019 to June 2022 were selected and divided into combination group (n =47) and control group (n =47) according to random number table. The control group received triamcinolone treatment, and the combined group received oral ulcer gel combined with triamcinolone treatment. Clinical indexes such as mouth opening, mucosal lesion area and pain before and after treatment were observed. Serum levels of interleukin-2 (IL-2), transforming growth factor-β₁ (TGF-β₁), tumor necrosis factor-α (TNF-α) and other inflammatory factors;Serum levels of neuron-specific enolase (NSE), cytokeratin 19 fragment (Cyfra21-1), squamous cell carcinoma antigen (SCC-Ag) and other tumor markers;Whole blood viscosity low cut (LS), plasma viscosity (PV), fibrinogen (Fib), and other hemorheological indexes. Adverse reactions were recorded for both groups.Results There were statistically significant differences in mouth opening, mucosal lesion area, VAS score and serum IL-2, TGF-β₁, TNF-α, NSE, Cyfra21-1, and SCC-Ag before and after treatment between the two groups (P <0.05). After treatment, the mouth opening degree in the combined group was higher than that in the control group, and the mucosal lesion area, VAS score and serum levels of IL-2, TGF-β₁, TNF-α, NSE, Cyfra21-1, and SCC-Ag in the combined group were lower than those in the control group (P <0.05). The difference of LS, PV and Fib before and after treatment between the two groups was statistically significant (P <0.05). After treatment, LS, PV and Fib in combination group were lower than those in control group (P <0.05). The total effective rate of combination group was higher than that of control group (P <0.05). During treatment, no significant adverse reactions were observed in both groups.Conclusion Oral ulcer gel combined with triamcinolone is effective in the treatment of OSF, which can reduce the levels of serum inflammatory factors and tumor markers and improve the hemorheology of patients with no significant adverse reactions.

Key words:oral submucosal fibrosis;oral ulcer gel;triamcinolone;inflammatory cytokines;tumor marker;hemorheology