伴放线菌嗜血菌在慢性牙周炎患者和牙周健康者中的分布

Distribution of Haemophilus actinomycetemcomitans in Chronic Periodontitis Patients and Periodontally Healthy Subjects

目的分析伴放线菌嗜血菌在慢性牙周炎患者和牙周健康者中的分布情况。方法选择116例慢性牙周炎患者(CP组)和111例牙周健康者(健康组)为研究对象。CP组选取磨牙区牙周袋最深的2个患牙的探诊深度最深点作为患牙的取样位点,同时选取磨牙或前磨牙区1个健康牙的近中位点作为健康牙的取样位点;健康组选取上颌第一磨牙近中位点作为取样位点。收集取样位点的龈下菌斑,提取DNA,用16S rRNA聚合酶链反应检测伴放线菌嗜血菌的分布;同时检查并记录取样牙的牙周临床指数(包括探诊深度、临床附着丧失和探诊出血),分析伴放线菌嗜血菌检出率和牙周临床指数的关系。结果CP组患牙伴放线菌嗜血菌检出率为33.62%,明显高于CP组健康牙和健康组(P<0.01)。伴放线菌嗜血菌检出率随着患者年龄的增加而降低,随着探诊深度、临床附着丧失的增加而增加,探诊出血阳性患牙的检出率(37.07%)也明显高于探诊出血阴性的患牙(7.41%)(P<0.05)。结论伴放线菌嗜血菌检出率随着牙周炎症程度的加重而升高,与慢性牙周炎的发生发展具有密切的联系。

Objective To investigate the prevalence of H.actinomycetemcomitans in Chinese chronic periodontitis （CP） patients and periodontally healthy adults. Methods 116 chronic periodontitis patients and 111 periedontally healthy adults were included. In each CP patient, subgingival plaque samples were collected from two sites of different molars with the greatest probing depth（PD） and one periodontally healthy site（PD≤3 mm）. The samples of periodontally healthy adults were obtained from the mesio-buccal site of one first upper molar. Bacteria DNA were extracted for detection of H.actinomycetemcomitans by 16S rRNA PCR. Results The prevalence for H.actinomycetemcomitans of diseased sites（33.62%） was significantly higher than that of healthy sites from CP patients（0.86%） and the periodontally sites（0.90%） （P〈0.01）. No significant difference was observed between male and female CP patients（P〉0.05）. A decreasing trend of H.actinomycetemcomitans was observed as the age increased. And the pocket depth and clinical attachment losswas associated with the occurrence of H.actinomycetemcomitans in a positive mode. And H.actinomycetemcomitans was more often detected in the bleeding sites on probing. Conclusion H.actinomycetemcomitans was more frequently detected in periodontitis sites than periodontally healthy sites. For CP patients, a higher prevalence was associated with the seriously involved sites than those moderate and mild implicated sites. H.actinomycetemcomitans is considered to be the one of the periopathogens involved in the etiology of chronic periedontitis.