米诺环素辅助治疗牙周炎前后牙龈卟啉单胞菌的定量检测

Detection and quantification of porphyromonas gingivalis in chronic periodontitis before and after minocycline hydrochloride therapy

目的对在基础治疗辅助米诺环素治疗慢性牙周炎前后,实时定量检测龈下菌斑中牙龈卟啉单胞菌(porphyromonas gingivalis,Pg)占总细菌构成比。方法收集中、重度慢性牙周炎患者50例,根据随机、自身对照的原则设计分组:未用药侧和药物侧(药物侧牙周基础治疗后牙周袋内放置盐酸米诺环素)。记录治疗前、治疗后1、3个月时各项临床指标,并提取牙周袋内菌斑,应用TaqMan Real-time PCR方法对龈下菌斑进行定量检测,对数据做统计学分析。结果 Pg构成比结果显示:两组治疗前均为68%,两组治疗后1个月未用药侧30%、药物侧28%;3个月时Pg构成比未用药侧24%,药物侧22%,均低于治疗前,差异有显著性意义(P<0.05);用药侧与未用药侧Pg构成比治疗后3个月均低于治疗后1个月,差异无显著性意义(P>0.05);用药侧治疗后1、3个月与未用药侧比较,差异无显著性意义(P>0.05)。Pg构成比与临床指标探诊深度、出血指数和牙周附着水平成正相关性(P<0.05)。结论牙周病患者经基础治疗后能够减少龈下菌斑中Pg的构成比,而且可以在3个月内保持疗效,其中牙周基础治疗起关键性作用,盐酸米诺环素辅助用药对临床治疗效果的改善不明显。

Objective Using the TaqMan Real -time PCR to compare between the scaling and root planting treatment （SRP） and SPR with minocycline hydrochloride for detection and quantification of Porphyromonas gingivalis （Pg） taken from subgingival plaque in moderate or severe chronic periodontitis .Methods We collected 50 cases of moderate to severe periodontitis patients , every patient＇s teeth were divided into two groups according to randomized control trial design as non-drug therapy （only SPR） and drug therapy （after SPR putting minocycline hydrochloride into periodontal pocket ）.To measure the Index at baseline before SPR .1 and 3 months after SPR or SPR and drug treatment , subgingival plaque sam-ples were collected and detected and quantified by the measurements of TaqMan Real -time PCR.To analyze the data u-sing SPSS 11.5 software.Results （1） Constitution ratio of Pg of the two groups： before the treatment, the data of two groups were 68%;after treatment 1 month the SPR group was 30%, SPR with minocycline was 28%, 3 month the SPR group was 24%, SPR with minocycline was 22%, after treatment 1 month and 3 month were reduced comparing with the one before treatment, the result was statistically significant （P0.05） . Constituent ratio of Pg between the two groups showed no difference before and after the treatment 1 and 3 mouths,the result was no statistically significant （P〉0.05）.（2）The relationship between constituent ratio of Pg and the clinical index such as PD, BI and AL showed positive correlation, the result was statistically significant （P〈0.05）.Conclusion Periodontal disease which is treated by SPR treatment or SPR with minocycline hydrochloride will reduce the number of Pg in subgingi -val plaque , and can maintain a therapeutic effect in three months .the SRP treatment plays a critical role and the improve-ment of clinical treatment effect using minocycline hydrochloride shows no obvious .