牙周病与冠心病相关性的文献系统评价

Systematic Review of the Correlation between Periodontal Disease and Coronary Heart Disease

目的评价牙周病与冠心病的关联程度,为制定预防措施提供依据。方法检索符合本研究分析条件的牙周病与冠心病相关性文献,采用Meta分析法,进行定量综合分析。运用Rev Man 4.2分析软件和SPSS 13.0统计软件计算相关危险因素OR或RR值及95%CI,并绘制森林图。结果共筛选出相关文献13篇,其中10篇为病例-对照研究,合并OR值为2.21,95%CI为1.91～2.56,3篇为队列研究,合并RR值=1.40,95%CI为1.28～1.54。对所有研究进行异质性检验,各研究差别无统计学意义(χ2=9.08,P=0.70),采用固定效应模型进行Meta分析,表明有无牙周病对患冠心病的危险性差别有统计学意义(RR=1.43,95%CI为1.35～1.52)。结论牙周病与冠心病呈显著相关性,且可能互为致病和加重病情的危险因素。

Objective To assess the correlation between periodontal disease （PD） and angiography-defined coronary heart disease （CHD）, providing a firm basis of the strategic prevention. Methods We conducted a systematic review of the published literatures about the relationship of PD and CHD. The data were analyzed by RevMan 4.2 software and SPSS 13.0 software. The values of OR/RR and 95%CI as the assessment of the link between PD and CHD were used, then drawing the forest plot. Results According to the inclusion criteria and exclusion criteria, 13 studies were selected, including 10 clinical controlled trails, OR was 2.21 （95%CI, 1.91 to 2.56） and 3 prospective cohort studies, RR was 1.40 （95%CI,1.28 to 1.54）. All studies were tested for heterogeneity χ^2=6.87, P=- 0.70〉0.05. Fixed effect model analysis showed that the summary RR was 1.43 （95%CI, 1.36 to 1.90）, indicating a higher risk of future coronary heart disease in individuals with periodontal disease compared with those without. Conclusion This result suggests that periodontal disease is significantly related with coronary heart disease, they may be a risk indicator for each other. However, we should strengthen the prevention and cure of PD and control the probability of CHD.