慢性牙周炎致病菌与冠状动脉粥样硬化相关性研究

Investigation of association between pathogens of chronic periodontitis and coronary atheroscleros

目的探讨慢性牙周炎与冠状动脉粥样硬化性心脏病(简称冠心病)发病的相关性机制。方法收集36例行冠状动脉搭桥手术并伴有慢性牙周炎患者的冠状动脉粥样硬化斑块和龈下菌斑,50例慢性牙周炎患者的龈下菌斑,采用Chelex-100法提取细菌DNA,以聚合酶链反应(PCR)法检测冠状动脉粥样硬化斑块和龈下菌斑中牙龈卟啉单胞菌(Porphyromonasgingivalis,Pg)、伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa)、具核梭杆菌(Fusobacterium nucleatum,Fn)、中间普氏菌(Preuotella intermedia,Pi)、福赛斯坦纳菌(Tannerella forsythensis,Tf)5种慢性牙周炎相关致病菌。结果 36例患者冠状动脉粥样硬化斑块中,各种牙周炎相关致病菌的检出率分别为:Pg 36%,Aa 3%,Pi 14%,Fn 25%,Tf 47%;同一患者冠状动脉粥样硬化斑块及龈下菌斑中同时检出5种牙周炎相关致病菌的一致的例数:Tf 15例,Pg 13例,Fn 5例,Pi 3例,Aa 0例;冠心病组的Pi检出率高于对照组,二者差异具有统计学意义(P<0.05)。结论在冠状动脉粥样硬化斑块中慢性牙周炎相关致病菌DNA的检出,提示慢性牙周炎相关致病菌在冠心病的发生、发展中可能起着重要的作用;中间普氏菌可能是冠心病的危险因素。

Objective To explore the possible correlation between coronary heart disease and periodontitis.Methods Subgingival plaque samples were collected from a total of 50 patients with chronic periodontitis,and coronary atherosclemtic plaques were collected from a total of 36 patients with periodontitis who scheduled for coronary artery bypass surgery.The bacterias DNA was obtained from subgingival plaque samples and coronary atherosclerotic plaques using the chelex-100 method.The extracted DNA was examined using the polymerase chain reaction（PCR）technique.Results In coronary atherosclerotic plaques samples from the 36 patients,the rates of periodontal bacteria were Pg 36%,Aa 3%,Pi 14%,Fn 25%,Tf 47%;The concordant presence of the same periodontal bacteria DNA in subgingival plaques and in coronary atherosclerotic plaques from the same patient was：Tf 15,Pg 13,Fn 5,Pi 3,Aa 0.Prevotella intermedia（Pi） rate of the coronary heart disease group was significantly higher,and the difference was statistically significant（P0.05）.Conclusions The presence of periodontal bacteria DNA in coronary atherosclerotic plaques could indicate that periodontal pathogenic bacteria may play a role in the coronary heart disease process.Prevotella intermedia may be the risk factors of coronary heart disease.