帕金森病中的口腔环境与吸入性肺炎风险：叙述性综述与概念框架。

文献信息

中文摘要

背景： 吸入性肺炎是帕金森病（PD）中的主要临床问题，并与不良预后相关。吞咽困难是公认的吸入性肺炎危险因素，但口腔环境也可能增加这一风险。
目的： 本叙述性综述旨在综合关于PD中口腔环境与吞咽困难关系的知识，并提出一个将口腔环境管理纳入吞咽困难管理的概念框架。
方法： 我们检索了PubMed、Scopus和Google Scholar中2000年1月至2025年12月发表的文献。我们综合了PD中口腔环境在三个领域（临床口腔表现、唾液相关症状和口腔微生物组）的研究结果，并在有报告时关注疾病分期，同时检查其与吞咽困难的关系。
结果： 据报道，PD中的口腔环境与疾病相关的运动和非运动特征有关，并随疾病进展而恶化。口腔环境的恶化也与吞咽困难相关。基于这些发现，我们提出了一个基于分期的概念框架，用于评估和管理口腔环境与吞咽功能。
结论： 在所有疾病阶段，对口腔环境和吞咽功能进行评估都应被视为PD中吸入性肺炎风险管理的一部分。即使在PD晚期，口腔环境仍是一个可改变的因素。

英文摘要

BACKGROUND: Aspiration pneumonia is a major clinical concern in Parkinson's disease (PD) and is associated with poor prognosis. Dysphagia is a well-recognized risk factor for aspiration pneumonia, but the oral environment may also contribute to this risk.
OBJECTIVE: This narrative review aims to synthesize knowledge on the relationship between the oral environment and dysphagia in PD and to propose a conceptual framework that incorporates oral environment management into dysphagia management.
METHODS: We searched PubMed, Scopus and Google Scholar for publications from January 2000 to December 2025. We synthesized findings on the oral environment in PD across three domains (clinical oral findings, saliva-related symptoms and the oral microbiome), with attention to disease stage where reported and examined their relationships with dysphagia.
RESULTS: The oral environment in PD was reported to be associated with disease-related motor and non-motor features and was reported to worsen with disease progression. Deterioration of the oral environment was also associated with dysphagia. Based on these findings, we proposed a stage-based conceptual framework for assessment and management of both the oral environment and swallowing function.
CONCLUSION: Assessment of both the oral environment and swallowing function across all disease stages should be considered as part of aspiration pneumonia risk management in PD. The oral environment remains a modifiable factor even in advanced stages of PD.