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TGF-β1 Stimulates Bone Resorption during Orthodontic Tooth Movement TGF-β1刺激正畸牙齿运动过程中的骨吸收
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.193
Jun Kikuta, Michiko Tsukada, K. Takagi, Mami Shimizu, T. Hikida, E. Nakayama, K. Kasai
BACKGROUND: Transforming growth factor(TGF)-β, which controls bone metabolism, is an important protein network. However, the relationship TGF-β and bone metabolism during orthodontic treatment of tooth movement is not well elucidated. PURPOSE: This study aimed to observe TGF-β1 expression on the compressed side of the periodontal tissue by moving rat teeth with orthodontic force in an animal experiment. In vitro, the change in TGF-β1 expression level when compression force(CF)was applied to human periodontal ligament(hPDL)cells was examined. MATERIAL AND METHODS: In vivo, 20 male rats were subjected to 10 g of orthodontic force for 7 days to move maxillary first molars in the mesial direction. Then, immunohistochemical analysis was performed to observe the expression of tartrate-resis-tant acid phosphatase(TRAP)and TGF-β1 protein in rat alveolar bone. In vitro, hPDL cells were used to study the effect of CF on TGF-β1 mRNA and protein expression. RESULTS: In vivo study, after 7 days, multinucleated cells and resorption lacunae were found on the surfaces of the alveolar bones in the 10-g group. Additionally, TGF-β1 immunoreactivity with orthodontic force was observed in the periodontal ligament (PDL)tissue on the 7th day. In vitro, TGF-β1 expression increased in the 1.0 g/cm² group compared to that in the control group in hPDL cells. CONCLUSION: Taken together, these results reveal that TGF-β1 expression is acti-vated in the periodontal tissue when optimal orthodontic force is applied. Moreover, it is possible that the TGF-β controls alveolar bone resorption during OTM.
背景:转化生长因子(TGF)-β是调控骨代谢的重要蛋白质网络。然而,在正畸治疗牙齿移动过程中,TGF-β与骨代谢的关系尚不清楚。目的:通过动物实验,通过正畸力移动大鼠牙齿,观察TGF-β1在牙周组织受压侧的表达。体外检测施加压缩力(CF)作用于人牙周韧带(hPDL)细胞时TGF-β1表达水平的变化。材料与方法:在体内,雄性大鼠20只,施加10 g正畸力7天,使上颌第一磨牙向近中方向移动。免疫组化法观察大鼠牙槽骨中抗酒石酸酸性磷酸酶(TRAP)和TGF-β1蛋白的表达。体外利用hPDL细胞研究CF对TGF-β1 mRNA和蛋白表达的影响。结果:体内实验7 d后,10 g组牙槽骨表面出现多核细胞和吸收腔隙。第7天观察牙周韧带(PDL)组织TGF-β1免疫反应性与正畸力的关系。在体外,与对照组相比,1.0 g/cm²组hPDL细胞中TGF-β1的表达增加。结论:综上所述,在最佳正畸力作用下,牙周组织中TGF-β1的表达被激活。此外,TGF-β有可能在骨移植过程中控制牙槽骨吸收。
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引用次数: 0
Effects of Inflammatory Cytokines on Follicular Dendritic Cell Secreted Protein Gene Transcription 炎症因子对滤泡树突状细胞分泌蛋白基因转录的影响
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.137
Yutaka Ikeda, Yasunobu Iwai, Y. Ogata
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引用次数: 0
Geographic Distribution of Dentists and Physicians in Comparison with Dental Hygienists and Nurses in Japan 日本牙医和内科医生与牙科保健员和护士的地理分布比较
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.122
Hiroya Gotouda, Yasuhiro Okamoto, Akina Okamoto, Akemi Kadowaki, Hiromi Nakazawa, M. Takasu, Fusami Shiina, Naomi Satou, Yoshie Masubuchi, Akie Kojima, S. Osawa, K. Matsune, H. Okada, Takanori Ito
The uneven regional distribution of healthcare workers is an important issue in the healthcare system and has been controversial worldwide. Even though policies that are intended to resolve the shortage of healthcare workers are established, the recruitment of most healthcare workers tend to be concentrated in urban areas, and the shortage of medical workers in rural areas remains unresolved. It is also important for medical and healthcare professionals from different disciplines to work as a team to provide medical care of interprofessional collaboration and integrated community for patients. Previous-ly, we reported on the regional distribution of dentists and physicians, university dental schools, medical schools, and postgraduate residents. In this study, we compared the number of dental hygienists and that of physicians and nurses to the current numbers of dentists by region and analyzed the examination numbers from 1958 to 2018 for dentists and physicians. The ratios of physicians and nurses per 100,000 population were relatively high in western Japan, particularly in the Kinki, Chugoku/Shikoku, and Kyushu/Okinawa regions. The ratio of dental hygienists per 100,000 population was also high in western Japan; however, there was no significant difference in the distribution of dentists. Although there was a significant correlation between the ratios of physicians and nurses at the prefectural level, no such correlation was observed for the ratios of dentists and dental hygienists. Our analyses revealed that, while the increase in the number of dentists during the previous decade(from 2008 to 2018)was gradual, the number of physicians increased at a more rapid rate. The ratio of dentists per 100,000 population in each prefecture was more uniform; however, the regional bias in the ratio of physicians remains unresolved. In conclusion, the results of our present study suggest that the uneven regional distribution of dentists in comparison with physicians in Japan has reduced recently and that the rate of increase in the number of dentists has also slowed down. Our study also found that the correlation between the regional distribution of dentists and dental hygienists was lower than that of the regional distribution of physicians and nurses.
卫生保健工作者的区域分布不均是卫生保健系统中的一个重要问题,在世界范围内一直存在争议。尽管制定了旨在解决保健工作者短缺问题的政策,但大多数保健工作者的招聘往往集中在城市地区,而农村地区的医务工作者短缺问题仍未得到解决。来自不同学科的医疗保健专业人员作为一个团队为患者提供跨专业协作和综合社区的医疗服务也很重要。以前,我们报道了牙医和医生、大学牙科学校、医学院和研究生住院医师的区域分布。在本研究中,我们比较了各地区牙科保健师、医生和护士的数量与目前牙医的数量,并分析了1958年至2018年牙医和医生的考试次数。在日本西部,每10万人中医生和护士的比例相对较高,特别是在近畿、Chugoku/四国和九州/冲绳地区。在日本西部,每10万人中牙科保健员的比例也很高;然而,牙医的分布并无显著差异。地级医师和护士的比例之间存在显著的相关性,但牙医和口腔卫生员的比例之间没有这种相关性。我们的分析显示,虽然在过去十年(2008年至2018年)牙医人数的增长是渐进的,但医生人数的增长速度更快。各县每10万人中牙医的比例较为统一;然而,医生比例的地区偏见仍未解决。综上所述,我们的研究结果表明,日本牙医与内科医生的区域分布不均衡的现象最近有所减少,牙医数量的增长速度也有所放缓。我们的研究还发现,牙医和牙科保健师的区域分布之间的相关性低于医生和护士的区域分布。
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引用次数: 0
The Survey Concerning the Promotion of Food and Nutrition Education among Dental Students : Part one in Reference to Oral Health and Eating Breakfast 促进牙科学生食品营养教育的调查:第一部分:口腔健康与吃早餐
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.129
Hiroya Gotouda, S. Osawa, Yasuhiro Okamoto, K. Matsune, Tetsuro Kono, H. Okada, Takanori Ito
The Japan Dental Association and the Japan Dietetic Association have released their Joint Declaration on the Promotion of Dietary Education for Health-Building. This declaration announces their intention to collaborate and cooperate as “food-related” professions in a national movement to widely promote food education and to help ensure that everyone has access to healthy and body enriching diets. Accordingly, the promotion of dietary education in dental and oral health is gaining increasing importance. In addition, food and nutrition education refers to developing and promoting knowledge regarding food among people to help gain the capability of selecting food that supports their prac-tical and healthy eating habits. Furthermore, in some countries, the relationships between food and nutrition education, that between nutrition and general health, and education about the importance of these factors for relevant medical professions are considered seriously. However, almost no survey research has yet been conducted on food and nutrition education for dental schools and dental students. This study reports the oral health and breakfast eating habits of dental students. Food and nutrition education for adolescents, including university students, plays an important role in promoting their health and well-being. Dental students who understand the need for balanced nutrition will be in a better position to share this knowledge with their future patients. As a part of this course, students were asked to review their dietary habits and were provided with appropriate understanding and the means to improve their own quality of life while focusing on lifestyle-related diseases and their prevention. In conclusion, our results suggest that a high proportion of students who had breakfast every day, woke up early and ate their breakfasts at family home, and then undertook long commutes to their schools. We also noted that a high proportion of the participants who indicated that they were in good health ate breakfast every day, while paying attention to obtaining nutritionally balanced meals and chewing their food slowly for optimal ingestion.
日本牙科协会和日本饮食协会发表了《促进饮食教育促进健康联合宣言》。本宣言宣布,他们打算在一项全国运动中作为“与食品有关”的专业人员进行协作和合作,以广泛促进食品教育,并帮助确保每个人都能获得健康和有益身体的饮食。因此,促进牙齿和口腔健康方面的饮食教育变得越来越重要。此外,食品和营养教育是指在人们中发展和推广有关食品的知识,以帮助他们获得选择食物的能力,以支持他们实用和健康的饮食习惯。此外,在一些国家,认真考虑食品与营养教育之间的关系、营养与一般健康之间的关系以及有关这些因素对相关医疗专业的重要性的教育。然而,目前几乎没有针对牙科学校和牙科学生的食品和营养教育进行调查研究。本研究报告了牙科学生的口腔健康和早餐饮食习惯。对包括大学生在内的青少年进行食品和营养教育,在促进他们的健康和福祉方面发挥着重要作用。了解均衡营养需要的牙科学生将更好地与他们未来的病人分享这些知识。作为这门课程的一部分,学生们被要求回顾他们的饮食习惯,并提供适当的理解和方法来提高自己的生活质量,同时关注与生活方式有关的疾病及其预防。综上所述,我们的研究结果表明,每天吃早餐的学生中,早起在家吃早餐,然后长途通勤到学校的比例很高。我们还注意到,在表示自己身体健康的参与者中,有很大一部分人每天都吃早餐,同时注意获得营养均衡的膳食,并慢慢咀嚼食物以获得最佳摄入。
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引用次数: 0
Deep Neck Infection Causing Abscess Formation due to Oral Infectious Disease 口腔感染性疾病引起深颈部脓肿的感染
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.158
Shigeo Tanaka, Maya Oshima, Chikashi Ishizawa, M. Komiya
Deep neck infections cause cellulitis or abscesses to form in the deep neck space. Despite advances in antibiotics, some advanced cases develop mediastinal abscess, sepsis, or disseminated intravascular coagulation, which can be fatal. In this retrospective cohort study, we included 34 patients to examine the factors involved in deep neck abscess severity. We evaluated and compared parameters like sex, age, causative disease, causative site, etc. Patient age was 8–78 years, with a higher proportion of males(24 cases; 70.6%)than females(10 cases; 29.4%). The causative tooth of the 31 cases of odontogenic infection(excluding three cases of osteomyelitis of jaw and peri-implantitis)was a mandibular molar in 30 cases(96.8%)and maxillary molar in one case(3.2%). Overall, the mean(± standard deviation)hospital stay was 22.7±20.3 days and was longer for females(31.0±20.3 days)than for males(19.2±19.6 days). C-reactive protein (CRP)levels were significantly correlated with hospital stay duration. Multivariate analysis revealed that patients with an abscess in the masticator, parapharyngeal, or anterior visceral space had significantly longer hospital stays. Patients with actinomycetes had significantly longer hospital stays. No significant differences in hospital stay were noted based on whether the patient was a compromised host. This study suggests that CRP levels, abscess location, and existence of actinomycete infection contribute to the severity of deep neck abscess.
深颈部感染导致蜂窝织炎或脓肿形成在深颈部空间。尽管抗生素取得了进展,但一些晚期病例会出现纵隔脓肿、败血症或弥散性血管内凝血,这可能是致命的。在这项回顾性队列研究中,我们纳入了34例患者,以检查深颈脓肿严重程度的相关因素。我们评估和比较了性别、年龄、病因、发病部位等参数。患者年龄8 ~ 78岁,男性比例较高(24例;70.6%)高于女性(10例;29.4%)。31例牙源性感染(不包括3例颌骨骨髓炎和种植周炎)的病原牙为下颌磨牙30例(96.8%),上颌磨牙1例(3.2%)。总体而言,平均(±标准差)住院时间为22.7±20.3天,女性(31.0±20.3天)比男性(19.2±19.6天)长。c反应蛋白(CRP)水平与住院时间显著相关。多变量分析显示,咀嚼肌、咽旁或前内脏间隙脓肿的患者住院时间明显更长。放线菌感染患者的住院时间明显延长。根据患者是否是受损宿主,住院时间没有显着差异。本研究提示,CRP水平、脓肿位置和放线菌感染的存在与深颈脓肿的严重程度有关。
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引用次数: 0
The SARS-CoV-2 Antibody Test to Identify the Infection Status of Dental Personnel 用SARS-CoV-2抗体检测检测口腔医务人员感染状况
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.146
A. Fukatsu, O. Tsuzukibashi, M. Fuchigami, C. Komine, Y. Konishi, Y. Ogura, H. Omori, Hidenori Suzuki, Katsuhiro Asaka, Yoshinori Ono, M. Fukumoto
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引用次数: 0
Distribution and Evaluation of Streptococcus sobrinus in Saliva Samples 唾液样品中sobrincoccus的分布及鉴定
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.117
Hiroya Gotouda, Noriko Shinozaki‐Kuwahara, M. Saito, O. Tsuzukibashi, A. Fukatsu, S. Osawa, K. Matsune, T. Kurita-Ochiai
Streptococcus mutans(S. mutans)and Streptococcus sobrinus(S. sobrinus)can be isolated from the human oral cavity. S. sobrinus varies in many aspects, including serotype, hemolytic nature, and glucan aggregation ability, distinguishing its properties and functions from those of S. mutans. In addition, S. sobrinus exhibits significant cariogenicity correlating with smooth-surface caries. Though identifying the behavior of S. sobrinus and its correlation with caries is essential, little research has been conducted to assess the utility of the distribution and reference levels of S. sobrinus in caries activity tests and risk diagnoses. The prevention of transmission of cariogenic bacteria is incorporated in food and nutrition education and support in maternal and child health. To further manage and prevent such transmission, health workers of interprofessional collaboration should also include infants in their healthcare plan, determine the number of S. mutans and S. sobrinus in the saliva of adults in their 20s to 30s, and manage the cariogenic risks. Hence, this study aimed to investigate and comparatively assess the number of S. sobrinus and the ratio of S. sobrinus to total Streptococci(Ss/Ts)using the saliva of adults in their 20s. The accumulated primary data will be used to develop a simple culture assay for caries risk assessment. Results revealed that when classifying risks into two levels according to the number of S. sobrinus, either of the following two categories is appropriate: ≥1.0 × 10 5 as high risk and ≤1.0 × 10 5 as low risk. The Ss/ Ts is also appropriate to classify the risk levels in either of the two categories as fol-lows: ≥0.1 % as high risk and ≤0.1 % as low risk. In conclusion, the results of the present study suggest that cell cultures can be used to compare and estimate the number of S. sobrinus and the Ss/TS ratio in saliva for caries risk
变形链球菌(S。变形链球菌)和黑链球菌(S。Sobrinus)可以从人类口腔中分离出来。sobrinus在血清型、溶血性质和葡聚糖聚集能力等诸多方面存在差异,这使得其特性和功能区别于变形链球菌。此外,S. sobrinus表现出明显的龋齿性,与光滑表面龋齿相关。虽然确定sobrinus的行为及其与龋病的相关性是必要的,但很少有研究评估sobrinus的分布和参考水平在龋活动测试和风险诊断中的效用。预防龋齿细菌的传播已纳入食品和营养教育以及对妇幼保健的支持。为了进一步管理和预防这种传播,跨专业合作的卫生工作者还应将婴儿纳入其医疗保健计划,确定20至30岁成人唾液中的变形链球菌和小链球菌数量,并管理其致龋风险。因此,本研究旨在利用20多岁成年人的唾液,调查并比较评估sobrinus的数量和sobrinus与总链球菌(Ss/Ts)的比例。积累的原始数据将用于开发一种简单的培养试验,用于龋病风险评估。结果表明,根据蛇蛉的数量将风险分为两个级别时,≥1.0 × 105为高风险,≤1.0 × 105为低风险。s/ Ts也适用于对两类中的任何一类的风险水平进行如下分类:≥0.1%为高风险,≤0.1%为低风险。总之,本研究的结果表明,细胞培养可以用来比较和估计S. sobrinus的数量和唾液中s/TS的比率,对龋齿的风险
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引用次数: 0
DNA Microarray Analysis of HSC-3 Human Oral Squamous Cell Carcinoma Cells Following Knockdown of DDIT4 敲除DDIT4后HSC-3人口腔鳞状细胞癌细胞的DNA微阵列分析
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.171
Masatoshi Suzuki, Chen Wang, Fengzhu Zhang, U. Bhawal, H. Yamaguchi, H. Okada
Oral squamous cell carcinomas(OSCCs)are the most common type of oral cancer and patients with OSCC have a poor prognosis and a low 5-year survival rate. Longer survival is correlated with lower expression of DNA Damage Inducible Transcript 4 (DDIT4)from certain types of cancer tissue. The primary object of this study was to explore the associated role of DDIT4 in human oral cancers. HSC-3 human oral squamous cell carcinoma cells were used to examine the effect of DDIT4 knockdown by a DDIT4 siRNA and the silencing efficiency was evaluated by quantitative real-time PCR (qRT-PCR). DNA microarray analysis was carried out on DDIT4 siRNA transfected HSC-3 cells using the Human Exon 1.0 ST array. Ingenuity Pathway Analysis(IPA)and Gene Ontology(GO)analysis were used for bioinformatics analysis to identify potential molecular functions and related pathways of differentially expressed genes(DEGs). The microarray results showed that 182 DEGs were upregulated, and 424 DEGs were downregulated in DDIT4-deficient HSC-3 cells. Among them, 4 genes(RNASE7, IL-24, SCD and MMP13)were selected to confirm the microarray results using qRT-PCR. IPA showed 49 related pathways are involved in DDIT4-deficient HSC-3 cells. GO analysis revealed that the GO terms of upregulated DEGs were regulation of transcription, membrane and protein binding while the GO terms of downregulated DEGs were signal transduction, membrane and protein binding. In conclusion, DDIT4 may serve as a key regulator in carcinogenesis and could be a therapeutic target in patients with OSCC.
口腔鳞状细胞癌(Oral squamous cell carcinoma, OSCC)是最常见的口腔癌类型,其预后较差,5年生存率较低。从某些类型的癌症组织中,较长的生存期与较低的DNA损伤诱导转录本4 (DDIT4)表达相关。本研究的主要目的是探讨DDIT4在人类口腔癌中的相关作用。以HSC-3人口腔鳞状细胞癌细胞为研究对象,检测DDIT4 siRNA敲除DDIT4的效果,并采用实时荧光定量PCR (qRT-PCR)评价其沉默效果。使用Human Exon 1.0 ST阵列对转染了DDIT4 siRNA的HSC-3细胞进行DNA微阵列分析。采用匠心途径分析(Ingenuity Pathway Analysis, IPA)和基因本体分析(Gene Ontology, GO)进行生物信息学分析,确定差异表达基因(differential expression genes, DEGs)的潜在分子功能和相关途径。微阵列结果显示,在ddit4缺失的HSC-3细胞中,182个deg上调,424个deg下调。其中选取RNASE7、IL-24、SCD和MMP13 4个基因,采用qRT-PCR对芯片结果进行验证。IPA结果显示,在ddit4缺失的HSC-3细胞中有49条相关通路参与。氧化石墨烯分析显示,上调的DEGs的氧化石墨烯项为转录、膜和蛋白质结合的调控,下调的DEGs的氧化石墨烯项为信号转导、膜和蛋白质结合的调控。综上所述,dddit4可能在癌变过程中起关键调节作用,可能成为OSCC患者的治疗靶点。
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引用次数: 1
Lacking Interleukin-10 Regulates the Inflammasome-driven Alveolar Bone Loss 缺乏白细胞介素-10调节炎症小体驱动的牙槽骨丢失
Pub Date : 2020-12-25 DOI: 10.5466/ijoms.19.184
R. Kobayashi, Yohei Watanabe, Takashi Saito, N. Tsuji, Tetsuro Kono, Miyuki Toda, H. Okada, T. Kurita-Ochiai
Periodontitis triggers inflammation by pathogenic factors such as periodontal pathogenesis, which is exacerbated by the alveolar bone resorption, causing the teeth to fall out. It is known that inflammatory factors such as inflammatory cytokines spread throughout the body through blood circulation and other means and become a risk factor for developing systemic diseases such as diabetes and arteriosclerosis. Immune responses play an essential role in defending against invasion by pathogenic microorgan-isms and maintaining and improving homeostasis. IL-10, an inhibitory cytokine produced by immune cells, plays an essential role in preventing the development of au-toimmune diseases caused by excessive immune responses by directly acting on immune cells and inhibiting their activation. However, the role in the steady-state remains unclear. In this study, we investigated the effects of IL-10 on periodontal tissue under steady-state conditions using IL-10 knockout(KO)mice. Significant alveolar bone resorption was observed in IL-10KO mice. The localization of osteoclast-like cells in the alveolar fossa by TRAP staining. Real-time PCR revealed an increased RANKL/OPG ratio, confirming that bone resorption occurred compared with wild type mice. Moreover, significant inductions of pro-IL-1β, pro-IL-18, and IL-17A specific mRNA were detected, and protein levels were also induced in these mice’s gingiva. Further-more, a significant increase in the expression of NLRP3, a representative marker of the inflammasome, was also observed in IL-10KO. These results indicate that IL-10 defi-ciency leads to alveolar bone resorption even under steady-state conditions. In particular, the markedly formed inflammasome was suggested to induce not only periodontitis but also systemic diseases.
牙周炎是由牙周发病机制等致病因素引发炎症,而牙周发病机制又因牙槽骨吸收而加剧,导致牙齿脱落。众所周知,炎症因子如炎性细胞因子通过血液循环等途径遍布全身,成为发生糖尿病、动脉硬化等全身性疾病的危险因素。免疫反应在抵御病原微生物入侵、维持和改善体内平衡中起着至关重要的作用。IL-10是一种由免疫细胞产生的抑制性细胞因子,通过直接作用于免疫细胞并抑制其激活,在预防过度免疫反应引起的自身免疫性疾病的发展中起着至关重要的作用。然而,它在稳定状态中的作用仍不清楚。在本研究中,我们利用IL-10敲除(KO)小鼠研究了稳态条件下IL-10对牙周组织的影响。IL-10KO小鼠有明显的牙槽骨吸收。TRAP染色观察破骨细胞样细胞在肺泡窝的定位。Real-time PCR显示RANKL/OPG比值增加,证实与野生型小鼠相比发生骨吸收。此外,在这些小鼠的牙龈中检测到il -1β、il -18和IL-17A特异性mRNA的显著诱导,以及蛋白水平的诱导。此外,IL-10KO中还观察到炎性小体的代表性标志物NLRP3的表达显著增加。这些结果表明,即使在稳态条件下,IL-10缺乏也会导致牙槽骨吸收。特别是,明显形成的炎性体被认为不仅会引起牙周炎,还会引起全身性疾病。
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引用次数: 0
Effects of General Anesthesia Using Remifentanil on Hemodynamics during Oral Surgery 瑞芬太尼全身麻醉对口腔手术血流动力学的影响
Pub Date : 2020-10-01 DOI: 10.5466/IJOMS.19.88
H. Yamaguchi, Masatoshi Suzuki, Mami Nakamura, R. Okamura, A. Tsuji, Takahiro Sasaki, K. Shibutani
used to achieve analgesia during general anesthesia. Due to excellent ad-justability, remifentanil, a strong opioid analgesic, is widely used during general anesthesia while performing oral surgery. However, caution is advised since remifentanil lowers blood pressure and heart rate. This study examined the effect of remifentanil on circulatory fluctuations while performing oral surgery under general anesthesia. The subjects were cases of general anesthesia performed in the hospital affiliated with our university between 2014 and 2017. Information was obtained from medical records and anesthesia minutes, regarding patient characteristics, surgical procedure, remifentanil use, drugs used to induce and maintain anesthesia, circulatory fluctuations during surgery, and management of hemodynamic events. Among the 1,474 cases in this study, remifentanil was used in 795 cases during general anesthesia(R group). Within R group, circulatory fluctuations appeared in 46 cases, the most common being bradycardia(22 cases)and hypotension(11 cases). A treatment for circulatory fluctuations(bradycardia [2.8%] and hypotension [1.5%])was administered in 54 cases(6.8%). Hypotension was often seen in the elderly and in patients who had taken hypotensive medicine prior to the surgery. Bradycardia often occurred during corrective surgery, open reduction, and internal fixation. Circulatory inhibition under general anesthesia occurs easily with remifentanil use, which has a parasympathetic nerve stimulation effect, during maxillofacial surgery and cervical procedures where vagal reflexes such as trigeminal nerve stimulation and carotid sinus compression are likely to occur.
用于全身麻醉时达到镇痛效果。瑞芬太尼是一种强效阿片类镇痛药,由于其良好的可调节性,被广泛应用于口腔手术全身麻醉。然而,由于瑞芬太尼能降低血压和心率,建议谨慎使用。本研究考察了全身麻醉下进行口腔手术时瑞芬太尼对循环波动的影响。研究对象为2014年至2017年在我校附属医院进行全身麻醉的病例。从医疗记录和麻醉记录中获得有关患者特征、手术程序、瑞芬太尼使用、用于诱导和维持麻醉的药物、手术期间循环波动和血流动力学事件管理的信息。本研究1474例患者中,795例患者全麻时使用瑞芬太尼(R组)。R组46例出现循环波动,以心动过缓(22例)和低血压(11例)最为常见。治疗循环波动(心动过缓[2.8%]和低血压[1.5%])54例(6.8%)。低血压常见于老年人和术前服用过降压药的患者。心动过缓常发生在矫正手术、切开复位和内固定期间。全身麻醉下使用瑞芬太尼容易发生循环抑制,因为瑞芬太尼具有副交感神经刺激作用,在颌面部手术和颈椎手术中,迷走反射如三叉神经刺激和颈动脉窦压迫很可能发生。
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引用次数: 1
期刊
International Journal of Oral-Medical Sciences
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