白塞病患者口腔溃疡的触发诱因为疲劳、精神压力和食物

作者：Volle G

译者：姚中强

摘要：目的:食物和其他外在触发因素在白塞氏病相关口腔溃疡复发中的作用和影响尚不明了。此调查研究了白塞氏病相关口腔溃疡复发的食物和非食物触发因素。

方法:在法国7家医院中随访的白塞氏病患者完成一个自助调查表。用开放问题寻找常规的及特殊的食物触发因素。调查表也包含封闭式问题，尤其重点评估6种常见触发情况和24种选定食品的效果。结果以阳性反应的百分数来描述。

结果:发放的101个调查表中，81份可用。这81个患者中， 96% 符合白塞氏病国际分类标准， 53% 患者描述其初始12个月中的口腔溃疡复发为“非常不舒服”或“不舒服”。对于6种常见情况， 50 患者(62%) 宣称≥1 项是“肯定的”口腔溃疡复发的触发因素。在开放和封闭问题中，最常见的触发因素是疲劳/压力 (37-47% 患者) 和食物(32-35%)。在24种食物中，最常见的触发因素为坚果 (48%)、菠萝 (42%)、花生 (32%)、瑞士干酪奶酪(30%)、 杏仁(23%)、柠檬 (22%)和其他奶酪 (21%) 。相应的开放问题的结果与之相符，但是频率更低。

结果:多数患者能确认白塞氏病相关口腔溃疡的触发因素，疲劳/压力和食物最常见的触发因素。口腔溃疡的处理必须考虑这些外在因素。常见口腔溃疡触发食物富含组胺或组胺释放成分提示过敏机制参与。

附原文：Abstract OBJECTIVES:The nature and impact of food and other external triggers in recurrences of Beh?et'sdisease (BD)-related oral ulcers (OUs) remain unknown. This survey investigated dietary and non-dietary triggers of BD-related OU recurrences.METHODS:Patients with BD who were followed in 7 French hospital departments completed a self-administered patient questionnaire. General and specific dietary triggering factors were sought in open questions. The questionnaire also included closed questions, notably to evaluate the effect of 6 general triggering situations and 24 selected foods. The results were expressed as number (%) of positive responses.RESULTS:Among the 101 questionnaires distributed, 81 were usable. Among the 81 patients, 96% fulfilled the International Criteria for Beh?et's Disease classification criteria and 53% qualified their OU recurrences during the previous 12 months as "very discomforting" or "discomforting". For the 6 general situations suggested, 50 patients (62%) declared ≥1 as a "sure" trigger of OU recurrences. In both open and closed questions, the most frequent triggers were fatigue/stress (37-47% of patients) and food (32-35%). Among the 24 suggested foods, nuts (48%), pineapple (42%), peanuts (32%), Emmental cheese (30%), almonds (23%), lemons (22%), and other cheeses (21%) were the most frequently reported. The corresponding open question gave consistent findings but with lower frequencies.CONCLUSIONS:Most patients can identify triggers of recurring BD-related OUs, with fatigue/stress and food representing the most frequent triggers. The management of OU must consider such external factors. The histamine-rich or -liberating properties of the commonly cited OU-triggering foods suggest a hyperreactivity mechanism.

引自：Volle G, Fraison JB, Gobert D, Goulenok T, Dhote R, Fain O, Gonzalez-Chiappe S, Lhote F, Papo T,Thuillier A, Rivière S, Mahr A. Dietary and Non-Dietary Triggers of Oral Ulcer Recurrences in Beh?et'sDisease.Author informationArthritis Care Res (Hoboken). 2016 Nov 18. doi: 10.1002/acr.23155. [Epub ahead of print]