硝苯地平致药物性牙龈增生的危险指征分析

Analysis of risk indicator for nifedipine-induced gingival hyperlasia

目的调查北京石景山区人群服用硝苯地平后出现药物性牙龈增生的患病率,并分析其危险指征。方法在北京石景山区进行横向调查,将616例患高血压或冠心病的个体纳入本项研究,其中205例患者服用硝苯地平(nifedipine)≥0.5年,411例未服用钙拮抗剂的患者作为对照组。通过问卷了解每例患者的人口学特征、刷牙出血情况、吸烟、糖尿病及用药情况,临床检查12颗前牙的龈沟出血指数(suleus bleeding index,SBI),同时用照片评价法判断牙龈增生的程度和菌斑指数。以牙龈增生程度≥38.6%作为判断个体牙龈增生的阈值。结果服用硝苯地平的患者牙龈增生的患病率为7.3%,显著高于对照组的1.2%。Logistic 回归分析结果表明,仅有 SBI 是该地区个体出现明显牙龈增生的相关因素(OR=5.92,P=0.001)。结论牙龈炎性反应是药物性牙龈增生的一个重要协同因素。

Objective To investigate the prevalence and risk indicator of nifedipine-induced gingival overgrowth in a community population in Beijing. Methods A cross-sectional survey was conducted in 616 community subjects with hypertension or coronary vascular disease in Beijing, China. Among them 205 individuals took nifedipine for at least half year and 411 individuals who had never received calcim channel blocker （CCB） were recruited as controls. Smoking, oral hygienic habit, systemic health, pharmacological and demographic data for each subject were recorded by questionnaire. Sulcus bleeding index （SBI） was assessed in 12 anterior teeth per subject. Turesky modified Quigley-Hein plaque index （PI） and gingival overgrowth index in anterior teeth were scored on photograph. 38.6% was defined as threshold to identify individual with significant gingival overgrowth. Results 7. 3% of the subjects taking nifedipine were found to have significant gingival overgrowth in this population. The prevalence of gingival overgrowth in nifedipine group was statistically higher than that in the control group. By logistic regression analysis, SBI was found to be the only risk indicator （ odds ratio = 5.92, P = 0. 001 ）. Condusions The presence of gingival inflammation was an important cofactor for the occurrence of gingival overgrowth.