GERD患者における口腔粘膜の状態および機能的パラメータと唾液中の一酸化窒素代謝物レベルとの相関について

The Oral Mucosa Status and the Correlation between the Functional Parameters and the Level of Nitric Oxide Metabolites in Saliva among Patients with GERD.

抄録

本研究は、18歳から70歳までのGERD患者91名（女性48名、男性43名）を対象とした。全患者は，一般臨床症状（吐き気，単発嘔吐，腹鳴，胸焼け，心窩部およびへそ周囲の痛み，食欲不振）とGERDの歯科的症状を含む単一のスキームにしたがって歯科臨床検査を受けた．歯科的状態の客観的評価として、混合唾液の機能パラメータ、唾液の緩衝能（BC）の測定、右耳下腺唾液腺（SRPSG）および血清中の一酸化窒素代謝物（NOx）含有量の検出（Griess反応を用いた安定代謝物：硝酸塩および亜硝酸塩の定量に基づく間接法）が行われた。その結果、ACRとSACRを有するGERD患者の唾液分泌量は正常値の下限（0.32+0.19ml/min）であり、SALCRを有する患者の唾液分泌量は低い（0.10+0.04ml/min）ことが判明した。唾液のBCは，ACRおよびSACRで高く（それぞれ9.07+1.23mmol eq/l，9.40+1.71mmol eq/l），SALCRで減少した（7.63+0.18mmol eq/l）．GERD患者のSRPSGにおけるNOx濃度は増加した（特にグループ3（20.93+11.23umol/l））。サイアロメトリーの指標である唾液のBC値とSRPSG中のNOx値との間に直接的な相関関係があることが確認された。

The study involved 91 patients (48 women and 43 men), aged from 18 to 70 years with GERD. All patients underwent the clinical dental examination according to a single scheme including general clinical manifestations (nausea, single vomiting, belching, heartburn, pain in the epigastrium and around the navel, and poor appetite) and dental manifestations of GERD. The objective assessment of the dental status of the examined patients included the measurement of the functional parameters of the mixed saliva, buffer capacity (BC) of saliva, and the detection of the nitric oxide metabolites (NOx) content in saliva from the right parotid salivary gland ("SRPSG") and in blood serum using the indirect method based on the determination of the stable metabolites: nitrates and nitrites using the Griess reaction. It was established that salivation rate among patients with GERD with the prevailing of ACR and SACR was at the lower limit of normal values (0.32 + 0.19 ml/min), and the salivation rate among patients with the prevailing of SALCR was low (0.10 + 0.04 ml/min). The BC of saliva among patients with the prevailing of ACR and SACR was high (9.07 + 1.23 mmol eq/l and 9.40 + 1.71 mmol eq/l, respectively) and was reduced among patients with the prevailing of SALCR (7.63 + 0.18 mmol eq/l). The NOx level in SRPSG among patients with GERD was increased (especially in Group 3 (20.93 + 11.23 umol/l)). The direct correlation between the indicators of sialometry, the level of the BC of saliva, and the NOx level in SRPSG were established during the study.