牙周治疗对冠心病合并牙周炎病人血清白介素-18和血脂的影响

Effect of periodontal therapy on IL-18 and lipid of serum in patients of coronary heart disease with chronic periodontitis

目的:牙周炎与冠心病之间的联系问题已经引起了医生的更多关注。本研究侧重牙周治疗能否对血清中的白介素-18(IL-18)及血脂产生影响并进行探讨。方法:对25名确诊同时患有冠心病、中、重度牙周炎的中老年病人(平均年龄64.32岁)在治疗前先进行牙周状况专科检查,采集血清;随即实施牙周基础治疗;牙周治疗完成后3个月再度采集病人血清,进行牙周状况专科检查。采用酶联免疫吸附法、自动生化分析仪分别对IL-18和血脂进行测定。结果:经过牙周治疗后所有病人的牙周临床指标(探诊深度,临床附着丧失、龈沟出血指数)均有好转(P<0.05);血清中IL-18水平明显降低(P<0.01);总胆固醇(TC-C)、低密度脂蛋白(LDL-C)、甘油三脂(TG-C)均降低(P<0.01,P<0.05,P<0.05),而高密度脂蛋白(HDL-C)升高(P<0.05))。结论:牙周指标的改善可能对血清中的炎性因子IL-18及血脂产生影响。为了证实这个观点还需要大规模的临床病例调查研究。

AIM ： To assess whether the periodontal treatment of periodontitis could influence the levels of IL - 18 and serum lipids in patients of cronic heart disease. METHODS： 25 patients with both CHD and moderate to severe periodontitis received intensive periodontal therapy. Blood samples were taken for t before and 3 months after periodontal therapy. IL - 18 was determined by sensitive enzyme - linked immunosorbent assay. Serum lipids were determined by auto biochemical analysis. RESULTS ： After periodontal treatment, all patients demonstrated significant improvement in clinical periodontal status including probing depth, clinical attachment loss and sulcus bleeding index （P 〈 0.05 ）. The level of IL- 18 in sera showed significant decreased （P 〈 0.01 ）. The level of total cholesterol （ TC - C ） ,low density lipoprotein cholesterol （ LDL - C ） and triglyeride cholesterol （ TG - C ） all decreased （ P 〈 0.01,P 〈 0.05, P 〈 0.05 ）. But the high density lipoprotein cholesterol （ HDL - C） was increased （ P 〈 0.05 ）. CONCLUSION： This study could provided that the improvement of periodontal status may influence the systemic inflammatory markers such as IL - 18 and serum lipids. An investigation with larger number of patients is needed to confirm this findings furtherly.