牙周炎患者高血压和颈动脉粥样硬化发病情况及其关系研究

摘要

目的：了解牙周炎患者高血压和颈动脉粥样硬化的发病情况，探讨牙周炎严重程度与高血压及颈动脉粥样硬化的关系。方法选择2012年6月—2015年6月在邯郸市中医院就诊的牙周炎患者400例，均进行牙周检查、血压测量及颈动脉超声检查，并检测血清超敏 C 反应蛋白（hs-CRP）、白介素6（IL-6）及肿瘤坏死因子α（TNF-α）水平。结果本组400例牙周炎患者中检出高血压186例（占46.50%），颈动脉粥样硬化72例（占18.00%），高血压并颈动脉粥样硬化37例（占9.25%），105例（占26.25%）患者为单纯牙周炎；轻度牙周炎160例，中度牙周炎133例，重度牙周炎107例。不同严重程度牙周炎患者性别、年龄、体质量、病程、高血压家族史阳性率、颈动脉粥样硬化家族史阳性率比较，差异均无统计学意义（P ﹥0.05）；重度牙周炎患者血清hs-CRP、IL-6、TNF-α水平高于轻度、中度牙周炎患者（P ﹤0.05）。不同严重程度牙周炎患者疾病构成比较，差异有统计学意义（P ﹤0.05）。高血压、颈动脉粥样硬化、高血压并颈动脉粥样硬化患者血清hs-CRP、IL-6、TNF-α水平高于单纯牙周炎患者，高血压并颈动脉粥样硬化患者血清hs-CRP、IL-6、TNF-α水平高于高血压、颈动脉粥样硬化患者（P ﹤0.05）。结论牙周炎患者高血压及颈动脉粥样硬化发生率较高，且牙周炎严重程度与高血压及颈动脉粥样硬化发生风险增高有关；炎性细胞因子在牙周炎、高血压及颈动脉粥样硬化的发生和发展过程中发挥着重要作用。%Objective To investigate the prevalence of hypertension and carotid atherosclerosis in patients with periodontitis,and to analyze the relationship between severity of periodontitis and hypertension, carotid atherosclerosis. Methods A total of 400 patients with periodontitis were selected in the Traditional Chinese Medicine Hospital of Handan from June 2012 to June 2015,all of them received periodontal examination,blood pressure measurement and carotid ultrasound examization,serum levels of hs-CRP,IL-6 and TNF-α were detected. Results Of the 400 patients with periodontitis,186 cases found hypertension( accounting for 46. 50% ),72 cases found carotid atherosclerosis( accounting for 18. 00% ),37 cases found hypertension complicated with carotid atherosclerosis(accounting for 9. 25% ),105 cases were isolated periodontitis (accounting for 26. 25% );160 cases were mild periodontitis,133 cases were moderate periodontitis,107 cases were severe periodontitis. No statistically significant differences of gender,age,body weight,course of disease,positive rate of family hypertension history or family carotid atherosclerosis history was found among patients with different severities of periodontitis(P﹥ 0. 05);serum levels of hs-CRP,IL-6 and TNF-α of severe periodontitis patients were statistically significantly higher than those of mild periodontitis patients and moderate periodontitis patients(P ﹤ 0. 05). There was statistically significant differences of disease constitution among patients with different severities of periodontitis(P ﹤ 0. 05). Serum levels of hs-CRP,IL-6 and TNF-α of hypertension patients,carotid atherosclerosis patients and hypertension patients complicated with carotid atherosclerosis were statistically significantly higher than those of isolated periodontitis patients,and serum levels of hs-CRP,IL-6 and TNF-α of hypertension patients complicated with carotid atherosclerosis were statistically significantly higher than those of hypertension patients and carotid atherosclerosis patients( P ﹤ 0. 05 ). Conclusion The prevalence rates of hypertension and carotid atherosclerosis are relatively high in patients with periodontitis,and the severity of periodontitis is correlated with the increased risk of hypertension and carotid atherosclerosis;inflammatory cytokines play important roles in the occurrence and development of periodontitis,hypertension and carotid atherosclerosis.