牙周干预治疗对牙周炎伴冠心病患者血脂水平及炎症因子的影响

摘要

Objective To investigate the effects of non⁃surgical periodontal treatment on lipid levels and inflammatory factors in pa⁃tients with periodontitis and coronary heart disease. Methods 83 cases of coronary heart disease patients with moderate and severe pe⁃riodontitis ( intervention group) and 50 cases of coronary heart disease patients without periodontitis ( control group) were selected. Ca⁃ses in intervention group received non⁃surgical periodontal treatment, which included oral hygiene instruction, ultrasound supragingival scaling, subgingival scaling and root planning, while the control group did not receive any intervention. The periodontal statuses of pa⁃tients in intervention group and control group were assessed. The inflammatory factors in gingival crevicular fluid and serum were all de⁃tected by enzyme⁃linked immunosorbent assay. Results The AL, PD, PLI and BLI of patients in intervention group after treatment were lower than those before treatment ( P<0.05) . The levels of IL⁃1β, IL⁃6 and TNF⁃αin serum and gingival crevicular fluid in inter⁃vention group after treatment were lower than those before treatment ( P<0.05) . The serum levels of TC, TG and LDL⁃C in intervention group were lower after treatment, while the levels of HDL⁃C and adiponectin were higher ( P<0.05) . Conclusion Non⁃surgical perio⁃dontal treatment could effectively improve periodontal status of patients with coronary heart disease and periodontitis, reduce the body's inflammatory response, and improve lipid metabolism. Thus, it could produce positive effect on the progression of coronary heart dis⁃ease.%目的：探讨牙周干预治疗对牙周炎伴冠心病患者血脂水平及炎症因子的影响。方法选取中、重度牙周炎伴冠心病患者进行牙周干预治疗83例（干预组）和冠心病不伴牙周炎患者50例（对照组），干预组患者采取口腔卫生指导、超声龈上洁治、龈下刮治和根面平整等干预措施，对照组不采取任何干预措施。对干预组和对照组患者牙周状况进行评估，检测患者血清和龈沟液中炎症因子。结果干预组患者干预治疗后临床附着水平、探诊深度、菌斑指数和出血指数均较低于干预治疗前（P＜0．05）；干预组患者干预治疗后血清和龈沟液中IL⁃1β、IL⁃6、TNF⁃α水平均低于干预治疗前（P＜0．05）；干预组患者干预治疗后血清TC、TG和LDL⁃C水平均较干预治疗前降低，而HDL⁃C和脂联素则较干预治疗前升高（ P＜0．05）。结论牙周干预治疗可有效改善牙周炎伴冠心病患者牙周状况，降低机体炎症反应，改善血脂代谢，从而可对冠心病病程进展产生正作用。