牙周非手术治疗对2型糖尿病伴慢性牙周炎患者牙周炎症控制及血清C反应蛋白水平影响的研究

摘要

目的 探讨牙周非手术治疗对中国广州地区汉族人群2型糖尿病伴慢性牙周炎患者牙周状况及血清C反应蛋白(C-reactive protein,CRP)的影响.方法 筛选135例2型糖尿病伴慢性牙周炎患者,以2:1的比例随机分为治疗组和对照组.治疗组90例接受牙周非手术治疗,对照组45例暂不进行牙周治疗,仅行与治疗组相同的口腔卫生宣教.观察2组患者基线及干预后6个月的牙周探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)及血清CRP水平的变化情况.结果 基线时Logistic回归分析显示平均PD是预测高水平CRP的危险因素(P＜0.05).相关性分析显示CRP与平均PD相关(r=0.230,P=0.009),与平均AL不相关(P＞0.05).治疗后,治疗组PD减少(0.48±0.45) mm,AL减少(0.32±0.51) mm,CRP下降(1.56±5.03) mg/L.治疗前后,治疗组PD(t=10.014,P=0.000)、AL(t=5.888,P=0.000)及血清CRP水平(t=3.157,P=0.000)的差异均有统计学意义;干预前后对照组各项指标变化的差异均无统计学意义(P＞0.05).两组平均PD(t=-3.318,P=0.001)的差异有统计学意义,而两组间平均AL和血清CRP水平的差异无统计学意义(P＞0.05).结论 牙周非手术治疗可有效改善2型糖尿病伴慢性牙周炎患者的牙周状况,尚不能确认牙周非手术治疗可显著改善2型糖尿病伴慢性牙周炎患者的血清CRP水平.%Objective To explore the effect of non-surgical therapy on control of periodontitis and serum CRP level in type 2 diabetic patients with chronic periodonfitis. Methods One hundred and thirty-five type 2 diabetic patients with chronic periodontitis were randomly assigned into two groups. Clinic index (PD, AL) and serum CRP level were examined in both groups before and after periodontal therapy. Results At the baseline, the mean PD emerged as a significant predictor for elevated CRP ( P ＜ 0.05 ). In correlation analysis, CRP was associated with mean PD ( r = 0. 230, P =0. 009 ), but not with mean AL( P ＞ 0. 05 ). In treatment group, reduction of PD was (0.48 ± 0. 45) mm, while reduction of AL was (0.32 ±0.51 ) mm, and reduction of CRP was (1.56 ±5.03) mg/L, there were statistically significant differences in PD ( P ＜0.05 ), AL ( P ＜0.05) and serum CRP level ( P ＜0.05 ) before and after non-surgical periodontal treatment. However, there was no significant difference ( P ＞0.05 ) of PD, AL and serum CRP level in control group during the time. There was significant difference ( P ＜ 0. 05 ) of mean PD between treatment group and control group,however, but no significant difference in mean AL and serum CRP level ( P ＞ 0. 05 ) between treatment group and control group. Conclusion Non-surgical periodontal treatment was helpful in improving periodontal status in type 2 diabetic patients with chronic periodontitis, but the evidence was not enough to support that non-surgical periodontal treatment could improve serum CRP level in these patients.