中、重度慢性牙周炎伴高血脂患者在牙周基础治疗后血脂的变化

Effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia

目的:观察牙周基础治疗对中、重度慢性牙周炎伴高血脂患者血脂水平的影响。方法:对20例中、重度慢性牙周炎伴高血脂的患者进行牙周基础治疗,在牙周基础治疗前及治疗后3个月检查患者的牙周探诊深度、附着水平、出血指数、探诊出血及菌斑指数,并且取静脉血检测血脂水平。结果:(1)牙周基础治疗后3个月,所有20例患者的牙周状况都明显改善,探诊深度、菌斑指数、出血指数及探诊出血位点百分比均显著降低(分别由3.98±0.12、1.23±0.10、2.63±0.14、94.26±1.84降至2.39±0.13、0.84±0.08、1.48±0.08、33.57±2.06,P<0.05),并有显著的附着获得(附着丧失由5.17±0.21降至3.92±0.16,P<0.05),说明牙周治疗效果显著,牙周感染的范围减少,炎症程度减轻。(2)牙周基础治疗后3个月,患者的血清总胆固醇和甘油三酯水平显著下降(分别下降了0.25 mmol/L和0.20 mmol/L,P<0.05),与此同时,高密度脂蛋白显著升高(升高了0.18 mmol/L,P<0.05),其中8例患者的血脂水平降至正常。结论:牙周基础治疗可减轻牙周组织炎症,并有利于降低中、重度慢性牙周炎伴高血脂患者的血清总胆固醇和甘油三酯水平,增高血清高密度脂蛋白的水平,因此有助于降低这类患者患冠心病等心血管疾病的风险。

Objective ： To observe the effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia. Methods： Twenty patients with both hyperlipidemia and moderate to severe chronic periodontitis were enrolled in this study. Periodontal parameters [ plaque index （PLI）, bleeding on probing （BOP）, bleeding index （BI）, probing depth （PD） and attachment level （AL） ] were evaluated prior to and 3 months after periodontal initial therapy. Simultaneously, the patients＇ serum levels of total cholesterol, triglyceride, high-lipoprotein cholesterol, low-lipoprotein cholesterol were also measured. Results： （ 1 ） Three months after periodontal therapy, the periodontal infection and inflammation in patients reduced comparing with baseline. The PD, PLI, BI, and BOP decreased significantly （the PD, PLI, BI, and BOP reduced from 3.98 ±0. 12 to 2. 39 ±0. 13, 1.23 ± 0. 10 to 0. 84 ±0. 08, 2.63 ±0. 14 to 1.48 ±0. 08 and 94.26 ± 1.84 to 33.57 ±2. 06,respectively;P 〈 0. 05 ）, and the attachment level increased significantly after periodontal treatment （AL decreased from 5.17 ±0.21 to 3.92 ±0. 16,P 〈0.05）. （2） The total cholesterol and triglyeeride levels in these patients also reduced significandy （ reducing 0.25 mmol/L and 0.20 mmol/L respectively, P 〈 0. 05 ） at 3 month after periodontal therapy comparing with baseline. At the same time, high-lipoprotein cholesterol levels in these patients increased significantly （ increasing 0. 18 mmol/L, P 〈 0. 05 ）. Eight out of 20 patients showed their serum levels of lipid down to the normal levels. Conclusion ： Our observation indicated that periodontal initial therapy could reduce the serum lipid levels of patients with both periodontitis and hypedipidemia, which might be helpful for decreasing risk of cardiovascular disease such as coronary heart disease.