目的：探讨牙周基础治疗对2型糖尿病伴中重度牙周炎患者血清肿瘤坏死因子-α( tumor necrosis factor-α,TNF-α)的影响。方法筛选57例2型糖尿病伴中重度牙周炎患者,随机分为治疗组和对照组。治疗组34例,接受牙周基础治疗,对照组23例,接受口腔卫生宣教。观察治疗前后2组平均探诊深度、临床附着水平、龈沟出血指数、糖化血红蛋白及血清TNF-α水平的变化情况。结果相较于基线期,牙周基础治疗6个月后,治疗组牙周指标均有明显改善：平均探诊深度由(2.90±0.78) mm降至(2.27±0.52) mm(t=8.526)；临床附着水平由(4.05±1.08) mm降至(3.52±1.10) mm(t=8.519)；龈沟出血指数由(0.37±0.17)降至(0.14±0.11)(t=11.496),差异均有统计学意义(P <0.05)。治疗组糖化血红蛋白水平由(7.22±1.30)%降至(6.73±1.12)%(t=3.210,P<0.05),差异有统计学意义。而治疗前后血清TNF-α差异无统计学意义(t=0.472,P>0.05)。对照组各项指标治疗前后比较差异均无统计学意义(P>0.05)。结论牙周基础治疗能有效改善2型糖尿病伴中重度牙周炎患者的牙周状况,降低糖化血红蛋白水平,但对血清TNF-α水平影响无统计学意义。%Objective To explore the effect of periodontal initial therapy on serum tumor necrosis factor-α ( TNF-α) level in type 2 diabetes patients with moderate to advanced periodontitis. Methods Fifty-seven patients of type 2 diabe-tes with moderate to advanced periodontitis were randomly assigned into two groups. The patients of treatment group were treated with periodontal initial therapy, while patients in control group were treated with oral hygiene instructions. Probing depth, clinical attachment level, sulcus bleeding index, glycosylated hemoglobin ( HbA1c) , and serum TNF-αlevel were examined in both groups before and after the periodontal initial therapy. Results Six months after periodontal initial therapy, all patients in the treatment group demonstrated significant improvement of the clinical periodontal status and the level of HbA1c ( P<0. 05) . The level of TNF-α didn”t change ( P>0. 05) . However, no significant differences were found ( P>0. 05) in control group. Conclusion Therapy is helpful in improving periodontal status and decreasing the HbA1c level, but not the TNF-α level in type 2 diabetes with moderate to advanced periodontitis.
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