مقايسه ميزان اجزاي C3 و C4 كمپلمان در ليكن پلان دهان و واكنشهاي ليكنوييد دارويي- تماسي دهان

Comparison of the Rate of Complement Components (C3, C4) in Patients with Lichen Planus and Lichenoid Reactions

مقدمه: ليكن‏پلان و واكنش‏هاي ليكنوييدي گروهي از ضايعات پوستي مخاطي هستند كه شيوع آن در بيماران ميانسال و در زنان بيشتر است. اين دو گروه بيماري از لحاظ كلينيكي و هيستولوژيك قابل افتراق نيستند. علت ليكن‏پلان مشخص نيست ولي علل مختلفي براي ضايعات ليكنوييد مطرح شده است. در اين تحقيق سعي شد از لحاظ اجزا كمپلمان سيستم ايمني، معياري براي تمايز اين بيماري‏ها به دست آورده شود. مواد و روش‏ها: اين مطالعه به صورت توصيفي- تحليلي انجام شد. جمعيت مورد مطالعه، شامل بيماران مراجعه ‏كننده به كلينيك يكي از متخصصان بيماري‏هاي دهان، فك و صورت شهر اصفهان بودند. نمونه‏ها شامل دو دسته 25 نفري از بيماران مبتلا به ضايعات ليكن‏پلان و واكنش‏هاي ليكنوييدي بودند. اين دو گروه بر اساس معيار‏هاي باليني و هيستولوژيك ارايه شده توسط WHO تمايز داده شدند. براي اجراي پژوهش، از هر دو گروه بيمار، 5 سي سي سرم خون گرفته شد و ميزان C3 و C4 آنان تعيين گرديد. تحليل داده‏ها با آزمون t-student و مجذور كاي دو انجام شد. يافته‏ها: آزمون t مستقل نشان داد كه ميانگين C3 در دو گروه با هم اختلاف معني‏داري نداشت (31/0P=). همچنين ميانگين C4 در دو گروه با هم اختلاف معني‏داري نداشت (31/0P=). به عبارت ديگر بين ميزان C4 و C3 با نوع بيماري (ليكن‏پلان دهاني و واكنش‏هاي ليكنوييدي) ارتباطي وجود نداشت. نتيجه گيري: ميزان C3 و C4 بيماران ملاك دقيقي براي تمايز اين دو بيماري نيست. از اين رو، لازم است از ملاك‏هاي تشخيصي ديگري استفاده گردد.

Introduction: lichen planus and lichenoid reactions are cutaneous-mocusal lesions that their prevalence is higher among adult and women. The mentioned diseases are not distinguishable from their clinical and histological features. Although, the etiology for lichen planus lesions is not determined, there are many different etiological reasons for lichenoid lesions. Both mentioned lesions are in immunological group. The main goal of this research was to determine the amount of Complement components such as (C3, C4) as a criterion for distinguishing these two lesions. Materials & Methods: The method of this research was descriptive and analytic. The research population were included the patients who referred to one of the expertise clinic of oral, facial and Jaw in Isfahan city. The statistical samples were included 2 groups of 25 patients who had lichen planus or lichenoid reactions lesions. 10cc of serum was taken from two groups of patients and measured their C3 and C4. Results: The results of this study indicated that the mean of C3 in the lichen planus group was 1.270 while in the oral lichenoid reactions was 1.332. Examining differences between means of two groups, t-test indicated that the mean of C3 between two groups did not have significant differences (P=0.31). The mean of C4 in the lichen planus group was 0.285 and in the lichenoid reactions group was 0. 328. t-test indicated that the mean of C4 two groups did not have any significant differences (P=0.31). In other words, there was not any relation between C3, C4 and the kind of diseases (lichen planus and lichenoid reactions). Conclusion: results indicated, there were not differences among two groups of patients in terms of their rate of C3 and C4. Therefore, measuring C3 and C4 could not be used as a precise criterion for distinguishing these mentioned diseases. For this reason, we should use other immunologic criteria for distinguishing between these two groups of lesions. For determining the diagnosis and distinguishing criteria, more research should be done with different groups and in different phases of disease such as exacerbation and remission phases.