牙侵蚀与胃食管反流病间关系.docVIP

牙侵蚀与胃食管反流病间关系 　　[摘要]牙侵蚀是指牙体硬组织在无细菌参与的化学作用下的不可逆性丧失，胃食管反流病是常见的胃肠道紊乱性疾病，是牙侵蚀主要的病因之一。本文主要就牙侵蚀的病因、胃食管反流病导致的牙侵蚀机制，牙侵蚀的临床表现，牙侵蚀的预防和治疗等研究进展作一综述。阐明了牙侵蚀是胃食管反流病食管外最重要的表现之一，其诊治需要多科的共同协作，早期诊断胃食管反流病并通过改变生活方式和药物来抑制酸反流，对预防牙侵蚀的发生和干预牙矿质的进一步丢失和损伤极为重要。 　　[关键词]牙侵蚀；胃食管反流病；唾液流速 　　[中图分类号]R 781.2[文献标志码]A[doi]10.3969/j.issn.1673-5749.2012.03.021 　　Relationship between dental erosion and gastroesophageal reflux diseaseHuang He1, Fa Yonghong2, Yang Yongjin2, Cai Xingwei2.（1. Graduate Academy of Liaoning Medical College, Jinzhou 121000, China; 2. Dept. of Stomatology, The Second Artillery General Hospital of Chinese People’s Liberation Army, Beijing 100088, China） 　　[Abstract]Dental erosion is the irreversible loss of dental hard tissue by chemical process in the absence of bacteria. Gastroesophageal reflux disease（GERD）is a common gastrointestinal disturbance disease, which considered to be one of the main causes to dental erosion. This review aimed to explore the pathogenesis and mechanism of dental erosion, in addition to explain the clinical manifestation, prevention and treatment of dental erosion. Dental erosion is considered to be one of the most important extra-oesophageal manifestations in patients with GERD. The diagnosis and treatment of dental erosion need to coordinate the department of digestive and the department of stomatology. Early diagnosis of GERD and suppress acid reverse flow through the lifestyle changes and drugs, and prevent dental erosion and further loss of teeth mineral and damage are very important. 　　[Key words]dental erosion；gastroesophageal reflux disease；salivary flow rate 　　牙侵蚀（dental erosion，DE）也叫牙酸蚀症，是牙体硬组织在化学作用下的不可逆性的脱矿破坏，在整个过程中都没有细菌的参与[1]。DE与龋病在病理和组织学表现上明显不同，龋病是由细菌产酸和蛋白酶作用所致的。DE的影响因素包括饮食习惯、酸性工作环境等外源因素以及持续的胃酸反流和慢性呕吐等内源性因素。胃食管反流病（gastroesophageal reflux disease，GERD）是常见的胃肠道紊乱性疾病，是由食管下括约肌的松弛引起的胃十二指肠内容物通过食管反流到口腔，继而产生的一系列慢性症状和食管黏膜损害。GERD的危险因素包括年龄（老年人）、性别（男性）、体重指数增加和吸烟以及种族、家族史、经济地位（高）等[2]，大约40%的健康人群自诉有过胃酸反流的经历[3]。GERD的典型症状是胃灼热、反酸、嗳气、吞咽困难和胸骨后疼痛，非典型症状为哮喘、慢性