盐酸米诺环素软膏局部应用对龈下菌群的影响

Effect on subgingival microfloral with local delivery minocycline-HCl ointment

目的:研究20 g/L盐酸米诺环素软膏局部应用后,牙周袋内龈下菌丛的变化。方法:重度慢性牙周炎患者洁治后,在牙周袋内置入20 g/L盐酸米诺环素软膏0.05 mL,于置药前及置药后2、6、120 h分别取龈沟液,用高效液相色谱法(HPLC)检测其中米诺环素浓度,并取龈下菌斑用细菌活力试剂盒染色,激光扫描共聚焦显微镜(LCSM)观察龈下菌群死活菌的比例及球菌、活动杆菌、螺旋体的比例变化。结果:龈沟液中盐酸米诺环素浓度在置药后120 h仍>1μg/mL,置药后龈下菌斑中死菌比例明显较置药前增高,置药后的龈下菌斑中球菌比例明显上升,活动杆菌及螺旋体比例显著下降。结论:20 g/L盐酸米诺环素软膏是一种缓释制剂;在一定浓度下既有抑菌作用又有杀菌作用;龈下菌斑的死活菌染色结合LCSM镜下检查可作为牙周健康状况及预后的评价方法。

AIM：Study the change of subgingival microbiota after local delivery 20 g/L minoeyeline - HC1 oinhnent. METHODS： After scaling, 8 patients with advanced periodontitis were selected to administer 0.05 mL 20 g/L minocycline - HCI oinlment into periodontal pocket. Drug concentration in GCF were determined by high - performance liquid chromatography （HPLC） prior to oiutment plavement and at 2 h, 6 h, 120 h after ointment placement, and suhgingival plaques were taken and stained by LIVE/DEAD BaeLight^TM Bacterial Viability Kits. The specimen were ohserved by laser confocal scanning microscope （ LCSM ） , in which the propnrtion of dead/live bacteria and pereentage of coccids, motile rods anti spiruchetes were calculated. RESULTS：The concentration of minocycline - HC1 in GCF can maintain high level （ 〉 1 μg/ml,） no less than 120 h. The proportion of dead bacteria in subgingival plaque significantly increased after ointment administer compared with that before. The proportions of subgingival coccids greatly increased, whereas motile rods and spirochetes devreased signifieantly. CONCLUSION ：20 g/L minocycline - HCl ointment is a sustained delivery system. It is confirmed that minocyeline has bactericidal effect,as well as bacteriostatie effect. The LIVE/DEAD slain of subgingival plaque combined with LCSM investigate can be served as a method to evaluate the periodontal heahh slalus and prognosis of periodontal disease.