慢性牙周炎龈下HCMV和EBV感染及其混合感染率与牙周病变程度的关系

Correlation of the subgingival infection and co-infection with human cytomegalovirus and Epstein-Barr virus in chronic periodontitis with severity of the periodontal lesions

目的了解慢性牙周炎(CP)龈下标本中人巨细胞病毒(HCMV)、Epstein-Barr病毒(EBV)感染和混合感染率及其与CP病变程度的关系。方法分别以HCMV糖蛋白B(gB)基因和EBV核抗原2(EBNA2)为靶基因,采用套式PCR(nPCR)检测130例CP患者、65例牙龈炎患者和35例牙周健康者共920份龈下标本中的HCMV及EBV-1和EBV-2。以牙龈指数(GI)、牙周附着丧失(AL)和牙周袋深度(PD)为观察指标,了解HCMV和EBV-1或EBV-2感染及其混合感染与CP牙周炎症和牙周破坏程度的关系。结果CP标本HCMV阳性率(63.5%)、EBV-1(27.9%)和EBV-2(9.8%)阳性率均显著高于牙龈炎(49.2%,16.9%,3.1%)和健康牙周标本(40.0%,13.6%,0.07%)。CP标本HCMV和EBV-1(18.5%)、HC-MV和EBV-2(7.5%)混合感染阳性率均显著高于牙龈炎标本(4.2%,0.08%)和健康牙周标本(2.1%,0.07%)。牙龈炎和健康牙周标本上述检测阳性率之间均无统计学差异。EBV-1或EBV-2感染与GI、AL、PD均无关。HCMV感染、HCMV和EBV-1及HCMV和EBV-2混合感染虽与GI均无关,但与AL和PD密切相关。结论HCMV或EBV-1、EBV-2感染可能参与CP发病。HCMV感染与CP牙周破坏中有重要作用,EBV-1与HCMV混合感染时可加重CP病变程度。

To understand the correlation of the subgngival infection and co-inection with humancytomegalovirus （HCMV） and Epstein-Barr virus （EBV） in chronic periodontitis with the severity of the periodontal lesions, the glucoprotein gene （gB） of HCMV and the EBV nuclear antigen-2 gene （ebnA2） from 920 subgingival specimens taken from 130 cases of chronic periodontitis, 65 cases of gingivitis and 35 healthy individuals without periodontal lesions were detected by means of nested PCR assay. The gingival index （GI） attachment loss （AL） and pocket depth （PD） were used as the observation indicators. It was found that the positive rates of HCMV,（63.5%）, EBV-1 （27.9%） and EBV-2 （9.8%） infections in chronic periodontitis were obviously higher than those in gingivitis （49,2 %, 16.9 % and 3.1%）, as well as those of the healthy individuals without peroodontal lesions （40.0 %, 13.6 % and 0.07 %） respectively. However, no significant difference existed in the detection rate between the gingivitis samples and samples taken from healthy individuals. Also, no correlation could be found among the EBV-1 or EBV-2 infection and GI, AL and PD. Although the HCMV infection, co-infection with HCMV and EBV-1 or HC- MV EBV-2 showed no relation to GI, but definite correlations could be demonstrated among infection or co-infection with ALand PD. All these results and statistical analysis lead to the conclusion that the infections with HCMC, EBV-1 or EBV-2 are involved in the development of chronic periodontitis in humans, and the co-infection with HCMV and EBV-1 can exacerbate the severity of disease.