牙周病患者唾液酶活性病理改变的初步探讨

A preliminary discussion with pathological changes of salivary enzyme activity in patients with periodontal diseases

目的探讨唾液酶活性在诊断牙周病中的意义。方法牙周病患者52例(其中牙龈炎18例、中度牙周炎23例和重度牙周炎11例)和健康对照20例被纳入研究。测定所有受试者唾液丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、γ-谷氨酰转移酶(GGT)和碱性磷酸酶(ALP)活性。结果方差分析(F检验)显示5种酶在所观察的疾病组间差异均有统计学意义(P<0.05)。ROC曲线分析显示:对诊断牙周病AST、ALP和LDH有较高特异性(均为95.0%),GGT的敏感度最高,为84.6%,LDH有较佳诊断效能,最大Youden指数为1.604,PPV=97.1%和NPV=51.4%。曲线下的面积以LDH为最大(0.856),其后依次是AST(0.781)、ALT(0.758)、GGT(0.757)和ALP(0.727)。结论唾液酶能反映牙周组织病变和损伤程度,以此提示唾液酶可能是诊断牙周疾病有用的指标。

Objective Discussion of saliva enzymes in diagnostic significance of periodontal disease.Methods Periodontal disease in patients with 52 cases（where gingivitis 18 cases of moderate periodontitis 23 cases and severe periodontitis 11 cases） and health study of 20 patients were included.The determination of all participants in the saliva alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,lactate dehydrogenase（LDH）,-glutamyl transferase（GGT and alkaline phosphatase（ALP） activity.Results Analysis of variance test（F） show the 5 enzyme in the observation of the disease among both significant differences（minimum statistics P= 0.002）.ROC curve analysis shows：on diagnosis of periodontal disease AST,ALP and LDH has the highest specificity（95.0%）,the highest sensitivity GGT,84.6%,LDH has the best diagnostic efficiency,maximum Youden index for 1.604,PPV = 97.1% and NPV = 51.4%.The area under the curve to LDH is Max（0.856）,followed the AST（0.781）,ALT（0.758）,GGT（0.757）,and the ALP（0.727）.Conclusion Salivary enzymes can reflect periodontal disease and injury,may be saliva enzyme are useful indicators for prompt diagnosis of periodontal disease.