牙周基础治疗对先兆流产孕妇炎症因子和妊娠结局的影响

摘要

目的 探讨牙周基础治疗对先兆流产孕妇血清炎症因子及其妊娠结局的影响.方法 选择出现先兆流产症状的孕妇80例(先兆流产组)及健康孕妇86例(正常妊娠组)作为研究对象,分别把上述2组中的牙周炎患者随机平均分入治疗组和非治疗组.对治疗组每例孕妇进行牙周基础治疗及定期维护,非治疗组仅进行口腔卫生宣教.分别于孕16周和分娩前检查其的牙周状况[龈沟出血指数(SBI)、探诊深度(PD)、附着丧失(AL)]和血清中细胞因子前列腺素E2(PGE2)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)的含量,并观察妊娠结局.结果 在孕16周时,先兆流产组的SBI、PD和AL位点率均高于正常妊娠组,差异有统计学意义,先兆流产组与正常妊娠组牙周治疗前后的SBI、PD的改善均有统计学意义,先兆流产组和正常妊娠组内各组孕16周和分娩前PGE2、TNF-α和IL-6的变化差异无统计学意义,且先兆流产组和正常妊娠组孕16周的炎症因子水平的差异也无统计学意义.先兆流产组和正常妊娠组早产低体重儿发生率的差异无统计学差异.结论 牙周治疗对于妊娠期妇女是安全的,并且可以有效改善其牙周状况,但无明显证据表明牙周治疗能够改变血液中炎症因子的水平和妊娠结局.%Objective To investigate the effects of periodontal basic therapy on pregnancy outcome and inflammatory cytokine of threatened abortion pregnant women. Methods Select 80 cases of pregnant women with threatened abortion symptoms as threatened abortion group and 86 cases of healthy pregnant women as normal pregnancy group. Select pregnant women with periodontitis from the above two groups, then randomly divided into treatment group and non-treatment group. For each treatment group the pregnant women were used periodontal treatment and regular maintenance, the non-treatment group accepted no special treatment except the oral hygiene instruction. Check the periodontal status [gingival sulcus bleeding index (SBI), probing depth (PD), and attachment loss (AL)] and the content of prostaglandin E2(PGE2), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in serum in week 16 of pregnancy and before delivery, record the pregnancy outcomes of each pregnant women. Results In week 16 of pregnancy the SBI, PD and AL rate of threatened abortion group were higher than in normal pregnancy group, the difference was statistically significant. The improvement of SBI and PD before and after the periodontal treatment in threatened abortion and healthy pregnant women group have statistical significance. There was no significant difference in the content of PGE2, TNF-α and IL-6 before and after treatment in each group, there was no significant difference in the incidence of preterm low birth weight also. Conclusion Periodontal therapy is safe for pregnant women and can effectively improve the periodontal status, but cannot change the level of inflammatory factors in the blood and the pregnancy outcomes.