代谢综合征病人牙周状况的研究

Study on periodontal status of patients with metabolic syndrome

目的:分析代谢综合征(metabolic syndrome,MS)病人牙周状况,探讨MS在牙周疾病的发生、发展中的意义。方法:选择150例诊断明确的代谢综合征病人为实验组,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。提取龈沟液,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-α(TNF-α)水平。测定空腹血糖水平、糖耐量、甘油三酯(TG)及高密度胆固醇(HDL-C)水平,测量血压、体质量指数(BMI)。对所得数据进行统计学分析。结果:MS组患牙周炎者121例占80.6.6%,高于对照组(72例,占48%),差异有统计学意义(P<0.01)。MS组的PD(4.9±2.1)、CAL(5.2±1.9)、BI(2.1±0.7)、重度百分比(17.9±12.4)及失牙数(0.9±1.2)除BI(1.7±0.4,P>0.05)外均高于对照组,差异有显著性(P<0.01)。MS病人龈沟液中IL-6、TNF-α、CRP水平均高于对照组,差异有显著性(P<0.01),而血清中两组无差异。相关性分析表明:MS组病人血糖水平与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,其他指标与牙周病的发病率无相关性。结论:MS病人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引发炎症的失衡而发生的。

AIM： To analyze periodontal status of patients with metabolic syndrome and to investigate the significance of metabolic syndrome in periodontal disease. METHODS： 150 patients of metabolic syndrome were chose, （MS） as the experimental group and 150 health adults as the control group. Plaque index（PLI） ,probing depth（ PD）, clinical attachment loss（ CAL）, bleeding index（ BI）, number of lose tooth and the percentage of pertodontitis were recorded and counted. The gingival erevicular fluid was aspirated and the level of IL -6 ,CRP, TNF - α were detected in the gingival crevicular fluid and the blood serum. The level of fasting blood sugar, carbohydrate tolerance, triglyceride, and HDL - C were detected. The blood pressure and BMI were measured. The principle of statistics was used to analyse the data . RESULTS： The number of patient and the percentage of AgD, CP with MS were higher than that of without MS. The difference was significant. The PD,AL, BI,percentage of severe sites and the number of losing tooth in group MS were higher than control gourp. The difference was significant（ P 〈 0.01 ）. The level of IL - 6, TNF - α, CRP in the gingival crevicular fluid in the MS group were higher than that of the control group. The difference was significent. But there was no difference between MS and the control group in the blood serum. The analysis of correlation displays that there was correlated between the levd 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 circumfer-ence. There was positive correlation between the level of HDL - C and PLI, CAL, BI, percentage of severe sites. There was no correlation betweent other index and the incidence of paradentosis. CONCLUSION ： The incidence of paraden- tosis in persons with MS are higher than the persons without MS. The level of blood sugar, HDL- C and adipositas are the important factors. This change may be be caused by the disbalance of the inflammation caused by MS.