代谢综合症患者牙周状况的临床研究

The study on periodontal status of patients with metabolic syndrome

目的:分析代谢综合症患者牙周状况,探讨代谢综合症在牙周疾病发生、发展中的意义。方法:选择150例诊断明确的代谢综合症患者为研究组,150例健康人作为对照组。检查记录:菌斑指数(PLI)、探诊深度(PD)、临床附着丧失(CAL)、出血指数(BI)、失牙数并计算牙周位点率。测定龈沟液及血清中白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-á(TNF-á)水平。结果:代谢综合症组患侵袭性牙周炎、慢性牙周炎高于对照组(P<0.01);代谢综合症组PD、CAL、重度百分比及失牙数除BI外均高于对照组(P<0.01)。代谢综合症患者龈沟液中IL-6、TNF-á、CRP水平高于对照组(P<0.01),而血清中两组无差异。相关性分析表明:MS组患者血糖水平与PLI、CAL、BI、重度百分比呈正相关(P<0.01),腹型(腰围水平)与PD、CAL、PLI重度百分比呈正相关(P<0.01)。HDL-C水平与PLI、CAL、BI、重度百分比及失牙数正相关。血糖及HDL-C水平与牙周病的发病率正相关。结论:MS患者牙周疾病的发病率明显高于正常人,其中血糖、HDL-C及肥胖程度是影响牙周状况的重要因素,这种变化可能是通过MS引发炎症失衡而发生的。

Objective： To analyze periodontal status of patients with metabolic syndrome and to explore the significance of metabolic syndrome （MS） in periodontal disease. Methods： 150 patients with metabolic syndrome were chosen as experimental group, while 150 healthy adults were as control group. Plaque index （PLI）,probing depth （PD）,clinical attachment loss （CAL）,bleeding index （BI）,the number of the lose tooth and the percentage of periodontitis were measured and recorded respectively. The level of IL-6,CRP, TNF-α in the gingival crevicular fluid and the blood serum were determined respectively. Results： AgD and CP incidences of MS group are significantly higher than that of control group （P〈0.01）.The PD,AL, BI,percentage of severe sites and the number of missing teeth in MS group were significantly higher than control gourp P〈0.01）. The levels of IL-6, TNF-α and CRP in the gingival crevicular fluid of MS group were higher significantly than those of control group, respectively. The difference between MS group and the control group is not significant. The analysis of correlation displayed that there was correlation between the level of PLI,AL,BI, percentage of severe sites and the level of blood sugar.The correlation could be seen between the level of PD,CAL,PLI, percentage of severe sites and the level of waist circumference.There was positive correlation between the level of HDL-C and PLI,CAL, BI, percentage of severe sites. Conclusion： The incidence of periodontitis in MS group is higher than that in control group. The level of blood sugar, HDL-C and adipositas play important roles in the periodontal condition.This change may be caused by the disbalance of the inflammation caused by MS.