糖尿病肾病与牙周病相关性研究

Correlation between diabetic nephropathy and periodontal disease

目的探讨糖尿病肾病与牙周病的相关性。方法选取新人院的2型糖尿病患者200例，根据24h尿微量白蛋白（MAU）水平分为3组：A组（正常蛋白尿组）：MAU〈30rag／24h；B组（早期糖尿病肾病组）：MAU30～300mg／24h；C组（临床糖尿病。肾病组）：MAU〉300rag／24h。采集患者的一般临床指标及反映肾功能的指标血肌酐（Scr）、血尿素氮（BUN），计算估算的肾小球滤过率（eGFR），并对患者进行牙周检查，检查指标包括出血指数（BI）、牙周探诊深度（PD）、临床附着丧失（CAL）及缺牙数目。结果（1）随着MAU水平升高，BI、PD、CAL及缺牙数目均明显增加（均P〈0．001）。（2）Logistic回归分析显示，PD、CAL及缺牙数目是糖尿病肾病发生的独立危险因素（P〈0．05或0．01）。（3）Scr与BI、PD、CAL及缺牙数目均呈正相关（r分别为0．212、0．267、0．324、0．316，均P〈0．01）；BUN与BI、PD、CAL及缺牙数目均呈正相关（r分别为0．147、0．168、0．268、0．334，均P〈0．05）；eGFR与BI无相关性（r=-0．137，P〉0．05），而与PD、CAL及缺牙数目均呈负相关（r分别为-0．213、-0．284、-0．339，均P〈0．01）。结论糖尿病。肾病与牙周病关系密切，牙周及牙齿缺失状况可以作为早期发现糖尿病肾病的线索。

Objective To explore the relationship between diabetic nephropathy （DN） and perio- dontal disease. Methods 200 new hospitalized patients with type 2 diabetes were enrolled. Subjects were further divided into three groups according to the level of microalbuminuria（MAU） ：group A （normal albumi- nuria group） ： MAU 〈 30 mg/24 h, group B （ early-stage DN group） ： MAU 30 - 300 mg/24 h, group C （ clini- cal DN group） ：MAU 〉 300 mg,/24 h. The clinical data and kidney function markers including serum creati- nine （Scr）, blood urea nitrogen（BUN） were collected, estimated glomerular filtration rate（eGFR） were cal- culated and the periodontal conditions including the periodontal pocket depth （PD）, bleeding index （BI）, clinical attachment loss （CAL） and tooth loss were detected. Results （1） BI, PD, CAL and tooth loss were increasing with MAU （P 〈 0.001 ）. （2） Logistic analysis showed that PD, GI and CAL were the independent risk factors of DN（ P 〈 0.05 or 0.01 ）. （ 3 ） Scr was positively correlated with BI, PD, CAL and tooth loss （ r = 0. 212,0. 267 ,0. 324,0.316 respectively, P 〈 0.01 ） ; BUN was positively correlated with BI, PD, C AL and tooth loss （r = 0. 147,0. 168,0.268,0. 334 respectively, P 〈 0.05 ） and eGFR was not correlated with BI （ r = - 0. 137,P 〉 0.05 ）, but negatively correlated with PD, CAL and tooth loss （ r = - 0. 213, - 0. 284, - 0.339 respectively, P 〈 0.01 ）. Conclusion There might be a correlation between periodontal disease and DN. The periodontal disease and tooth loss could be an indicator for early detection of DN.