伴牙周炎糖尿病患者血清和龈沟液中C反应蛋白的检测及意义

Evaluation of C-reactive protein levels in serum and gingival crevicular fluid in type 2 diabetes patients with periodontitis

目的:了解龈沟液和血清中C反应蛋白(C-reactive protein,CRP)水平与牙周炎症状况、血糖控制情况的关系。方法:检测伴慢性牙周炎2型糖尿病组、慢性牙周炎组、2型糖尿病组和健康人群组血清和龈沟液中CRP浓度、糖化血红蛋白(glycosylated hemoglobin,HbAlc)水平,记录牙周探诊深度(probing depth,PD)和龈沟出血指数(sulcus bleeding index,SBI)。采用SPSS10.0软件包进行独立样本t检验和Spearman相关分析。结果:伴慢性牙周炎2型糖尿病组、慢性牙周炎组、2型糖尿病组血清CRP均比正常对照组显著升高(P<0.01),且伴慢性牙周炎2型糖尿病组血清CRP水平最高,显著高于慢性牙周炎组(P<0.01)和2型糖尿病组(P<0.05);4组的龈沟液CRP水平均远低于血清水平,且4组间无显著差异(P>0.05);血清CRP与龈沟液CRP无相关性(P>0.05);血清CRP与PD、SBI和HbAlc显著相关(P<0.01)。结论:CRP可能参与了牙周炎和2型糖尿病之间的互相影响;龈沟液CRP水平不能反映牙周病炎症程度和糖尿病病情。

PURPOSE： To observe the relationship of the C-reactive protein （CRP） levels and the severity of the periodontal inflammation and the diabetes glyeemie control. METHODS： The CRP levels in serum and in gingival cervicular fluid（GCF） in type 2 diabetes patients with chronic periodontitis, patients with periodontitis alone, patients with type 2 diabetes alone and healthy people were assayed. Glycosylated hemoglobin （HbAlc） in serum was detected. Probing depth （PD） and sulcus bleeding index （SBI） were recorded. The data were analyzed by non-paired t test and Spearman correlation analysis with SPSS 10.0 software package. RESULTS： The serum CRP levels in type 2 diabetes patients with periodontitis and periodontitis and type 2 diabetes were significantly higher than those in healthy group （P〈0.01）. Serum CRP levels in type 2 diabetes patients with periodontitis were the highest and were significantly higher than that in periodontitis group （P〈0.01）and type 2 diabetes group （P〈0.05）. However, the CRP levels in GCF in each group were far lower than those in serum and no difference was detected in the four groups （P〉0.05）. The CRP levels in serum didn＇t ton＇elate to the CRP levels in GCF （P〉0.05）.The CRP levels in serum correlated to PD, SBI and HbAlc （P〈0.01）. CONCLUSION： CRP may be involved in the interaction of chronic periodontitis and type 2 diabetes. The CRP levels in GCF could not reflect the inflammation of the periodontitis or the condition of diabetes. Supported by Natural Science Foundation of Shanghai Municipality（Grant No.07ZR14071）.