唾液潜血与口腔硫化物水平的相关分析

Relationship between salivary occult blood and level of volatile sulphur compounds in oral cavity

目的 探讨牙周基础治疗后唾液潜血的转归及其与口腔挥发性硫化物（volatile sulphur compounds,VSC）、牙周临床指标的关系,以期评价唾液潜血在牙周疾病及口气诊疗中的作用.方法 对50例菌斑性龈炎或轻、中度慢性牙周炎患者行牙周基础治疗,治疗前、后分别用口气检测仪（Halimeter）检测口腔VSC水平,用潜血试纸检测唾液潜血,并依次记录全口菌斑指数（plaque index,PLI）、探诊深度（probing depth,PD）、出血指数（bleeding index,BI）及Ramfj（o）rd指数牙的附着丧失（attachment loss,AL）.结果 治疗前唾液潜血与BI（r=0.294）及PU（r=0.308）呈显著正相关（P〈0.01）;治疗后唾液潜血与口腔VSC水平（r=0.386）、PLI（r=0.456）、BI（r=0.352）、AL（r=0.325）显著正相关（P〈0.05）;唾液潜血阳性转阴性率达80%（40/50）;治疗后PLI（0.4±0.6）、BI（0.4 ±0.7）、AL[（0.1±0.5）mm]、PD[（2.7±0.9）mm]、口腔VSC水平[（100.0（46.3-165.3）×10-9]均较治疗前[分别为（1.3±1.0）、（1.8±1.2）、（1.0±1.1）mm、（3.7±1.5）mm、211.0（111.0～389.5）×10-9]显著降低（P〈0.001）.随着唾液潜血由强阳性到阴性的变化,口腔VSC水平和各牙周临床指标逐渐降低,该趋势差异有统计学意义（P〈0.001）.结论 唾液潜血是判断个体牙龈炎症程度的客观指标,与治疗后的口腔VSC密切相关.

Objective To observe the change of the salivary occult blood after periodontal mechanical therapy,and to assess the correlations between salivary occult blood and the level of volatile sulphur compounds （VSC） in oral cavity,periodontal clinical parameters,respectively.Methods Fifty patients with gingivititis,mild or moderate periodontitis were included.The level of VSC were measured by Halimeter（R） and salivary occult blood was tested by Periosereen（R） before periodontal examination.Then full mouth plaque index （PLI）,probing depth （PD）,bleeding index （BI） were charted.Attachment loss （AL） of the Ramfj（o）rd teeth were recorded lastly.Intensive periodontal mechanical therapy was conducted including oral hygiene instruction,scaling and root planing（SRP）.Four weeks after SRP,the same examinations were repeated.Results Salivary occult blood was significantly correlated with BI （r = 0.294） and PLI （r =0.308） before periodontal therapy （P 〈 0.01）,and also significantly correlated with VSC level （r = 0.386）,PLI （r = 0.456）,BI （r = 0.352）,AL（r = 0.325） after therapy （P 〈 0.05）.The improvement of VSC level [211.0（111.0-389.5）×10-9 vs 100.0（46.3～165.3）× 10-9],the clinical periodontal parameters including PLI[（1.3 ±1.0） vs （0.4±0.6）],PD[（3.7±l.5）mmvs （2.7±0.9）mm],BI[（1.8±1.2）vs （0.4±0.7） ]and AL[（1.0± 1.1）mm vs （0.1±0.5） mm after the treatment was statistically singnificant（P 〈0.001）.However,standing on the viewpoint of salivary occult blood changes from positive before therapy to negative after therapy,only 80% （40/50） individuals were totally cured.VSC level in oral cavity and periodontal clinical parameters significantly decreased （P 〈 0.001） following the trends from strong positive,weak positive,to negative results of salivary occult blood test .Condnsions Salivary occult blood was correlated with VSC level in oral cavity of periodontal treated patients.It may be an objective parameter to evaluate the gingival inflammation and the efficacy of the periodontal therapy at individual level.