2型糖尿病血糖控制水平对种植体稳定性和血液炎症指标的影响

摘要

Objective To investigate the effects of blood glucose levels in type 2 diabetes mellitus (T2DM) on im⁃plant stability and blood inflammatory markers. Methods 35 patients with T2DM were selected as the observation group, and 30 healthy individuals were included in the control group. All the patients received implant surgery. The lev⁃el of the blood glucose control, the inflammatory indexes of blood, and the implant stability were recorded and analyzed. Results There was no significant difference in the inflammation indexes between the 2 groups before surgery (P >0.05). The numbers of white blood cells, grain cells and lymphocyte in the observation group were significantly higher than those in control group after implantation (P<0.01). The immediate implant torque values were (32.65 ± 3.48) N·cm and (28.75 ± 3.64) N · cm in control group and observation group respectively, and the average torque value of the con⁃trol group was significantly higher than that of the observation group (t = 2.945, P = 0.016). The postoperative implant stability quotient (ISQ) decreased at first, and then increased gradually. There was no significant difference in ISQ be⁃tween the 2 groups at the early stage (P > 0.05), what��s more, when ISQ decreased to the lowest level after 2 weeks, there was no significant difference either (P>0.05). Individuals with worse blood glucose level control were observed to have a longer time to recover the ISQ level (P<0.05). Conclusion Blood glucose level may have some effects on the inflammatory reaction and implant stability in the patients with T2DM.%目的：探讨2型糖尿病不同血糖水平对种植体稳定性和血液炎症指标的影响。方法选取接受种植牙手术的35例2型糖尿病者为观察组，同期选择30例血糖正常的种植牙患者作为对照组，观察2组患者种植术后的血糖控制水平、血液炎症指标和种植体稳定性。结果种植手术前2组患者血液炎症指标差异无统计学意义（P>0.05），术后观察组白细胞、中粒性细胞及淋巴细胞数高于对照组，差异有统计学意义（P＜0.01）。对照组种植体植入后即刻扭矩值为（32.65±3.48）N·cm，观察组种植体植入后即刻扭矩值为（28.75±3.64）N·cm，对照组平均扭矩值高于观察组，差异有统计学意义（t=2.945，P=0.016）。术后2组患者种植体稳定系数（implant stability quotient ，ISQ）均呈早期下降而后回升并渐强的趋势，初期不同血糖控制水平患者间ISQ差异无统计学意义（P>0.05），术后2周不同血糖控制水平患者间ISQ下降至最低值时差异仍不明显（P>0.05）；血糖越高，种植体ISQ下降越多（P＜0.01），血糖越高，其ISQ恢复时间越长（P>0.05），对照组及血糖控制良好者，ISQ恢复时间显著短于血糖控制不良及中等控制者（P＜0.05）。结论2型糖尿病患者牙种植体植入后的稳定性和血液炎症指标与血糖控制水平密切相关。