侵袭性牙周炎患者非手术治疗的临床疗效和血液指标的远期观察

摘要

目的 分析广泛型侵袭性牙周炎患者(generalized aggressive periodontitis,GAgP)非手术治疗的远期临床疗效和对血液指标的影响,以期为临床提供参考.方法 纳入全身健康的25例GAgP患者(GAgP组)和28名年龄、性别与之匹配的牙周健康者(健康对照组),检查并记录探诊深度(probing depth,PD)、出血指数(bleeding index,BI)和附着丧失(attachment loss,AL)等牙周指标,检测血细胞分析和血清生化指标；GAgP组进行牙周非手术治疗,于治疗后3～7年复查,记录PD、BI、AL并再次检测血液指标；健康对照组不做复查.GAgP组与健康对照组血液指标比较采用Student-t检验,GAgP组治疗前后的牙周临床指标比较采用单因素方差分析、血液指标比较采用配对t检验.结果 GAgP组治疗前的血清总蛋白水平[(78.2±4.4)g/L]、球蛋白水平[(29.3±3.8)g/L]、外周血中白细胞数目[(6.3±2.0)×109个/L]、中性粒细胞百分比[(64.3±7.8)％]和绝对值[(4.1±1.8)×109个/L]均显著高于健康对照组[分别为(75.6±4.6)g/L、(26.5±3.9)g/L、(5.4±1.0)×109个/L、(55.8±11.1)％、(3.0±0.9)×109个/L],白蛋白与球蛋白比值(1.7±0.2)显著低于健康对照组(1.9±0.3).牙周非手术治疗3～7年后,GAgP组PD、BI显著降低,各项血液指标均较治疗前更趋向于健康对照组.结论 牙周非手术治疗对GAgP患者具有一定的远期疗效,不仅牙周临床指标改善,血液学指标亦更趋向于健康.%Objective To investigate the long-term effects of non-surgical treatment on clinical and hematologic states of patients with generalized aggressive periodontitis (GAgP).Methods Patients with GAgP(n =25) and healthy controls (n =28) were recruited.The clinical parameters,including probing depth(PD),bleeding index(BI),attachment loss(AL) were examined and recorded.Blood cell variables,including white blood cells (WBC),leukocyte,neutrophil,and lymphocyte counts,as well as serum triglycerides,fasting glucose and protein parameters,including total protein,albumin,globulin,and albumin/globulin ratio(A/G),were analyzed.Twenty-five GAgP patients received non-surgical treatment and the clinical and blood parameters 3 to 7 years after treatment were re-evaluated.Clinical and hematological parameters of the two groups were compared.Comparisons of clinical and hematologic parameters pre-and post-treatment in GAgP group were performed through one-way ANOVA and paired-t test.Results Elevated white blood cells,neutrophil numbers and serum total protein,globulin levels were observed in patients with GAgP compared to controls [(6.3 ± 2.0) × 109cell/L vs.(5.4 ± 1.0) ×109cell/L,(4.1 ±1.8) × 109 cell/L vs.(3.0 ±0.9) × 109 cell/L,(78.2 ±4.4) g/L vs.(75.6 ±4.6) g/L and (29.3 ±3.8) g/L vs.(26.5 ±3.9) g/L respectively,P ＜0.05].A/G ratio was lower in the GAgP group than in the control group (1.7 ±0.2 vs.1.9 ±0.3,P ＜0.01).Three to seven years after periodontal treatment,the reduction of PD and BI was observed in GAgP group (P ＜ 0.05).There were significant decreases of WBC count,neutrophil count,serum total protein and globulin level,and significant increases of albumin level and A/G at 3 to 7 years after treatment (P ＜ 0.05).Conclusions Non-surgical treatment may have long-term beneficial effect on the periodontal clinical status and hematologic parameters of generalized aggressive periodontitis.