陈旧性心肌梗死患者的牙周状况

Periodontal status of patients with post-acute myocardial infarction

目的:明确陈旧性心肌梗死患者牙周状况,探索中老年人群中慢性牙周炎与陈旧性心肌梗死的相关性。方法:对103名陈旧性心肌梗死患者和52名健康志愿者进行牙周临床检查,记录缺失牙数、菌斑指数、出血指数、探诊深度、附着丧失(attachment loss,AL),进行单因素和多因素分析,观察各牙周指标与心肌梗死的相关性。结果:陈旧性心肌梗死患者缺牙数(6.89±7.39 vs.4.21±5.62,P<0.05))、AL[(3.48±2.34)mm vs.(2.61±1.85)mm,P<0.05]及重度牙周炎患病率(44.7%vs.32.7%,P<0.05)均高于对照组。调整性别、年龄、吸烟、肥胖、糖尿病、高血压、高血脂等危险因素后,AL≥4.00 mm是心肌梗死的独立危险指征(OR=4.89,95%CI:1.26～18.94,P=0.02)。结论:陈旧性心肌梗死患者牙周状况较健康者差;因牙周炎导致的附着丧失与陈旧性心肌梗死存在相关性。

Objective ： To evaluate the periodontal status of post-acute myocardial infarction patients, to identify whether periodontitis is associated with post-acute myocardial infarction in Chinese community population. Methods： Case and control subjects were enrolled from a community population, the diagnose of post-acute myocardial infarction and systemic health were based on blood, electrocardiogram and uhra- sound examinations by physicians. Full mouth periodontal examinations were performed in 103 post-acute myocardial infarction patients and 52 healthy subjects. Mesial-buecal and distal-lingual sites per tooth were examined. The periodontal parameters including plaque index （PLI）, bleeding index （BI）, pro- bing depth （PD）, attachment level （AL） and missing teeth number were recorded. Information of demo- graphic data, behavior habits and general conditions were obtained by a questionnaire. Periodontal status were compared between case and control groups, the association between AL, PD, PLI, missing teeth and post-acute myocardial infarction was analyzed by Logistic regression. Results： In post-acute myocar- dial infarction group, there were 83 males, 20 females, mean age was 68 （41 to 84）years old, in healthy subjects there were 30 males and 22 females,mean age was 62（42 to 78） years old. There were no statis- tically differences between two groups in age structure, smoking condition, education status and working condition, but body mass index, total cholesterol, triglycerides and glucose in post-acute myocardial in- farction group were significantly higher than that in healthy group, while high-density lipoprotein significant lower. The number of missing teeth （6.89±7.39 vs. 4.21 ＋ 5.62, P = 0.01 ）, mean AL[ （ 3.48±2.34） mm vs. （2.61±1.85） mm, P =0.02] and prevalence of severe periodontitis （44.7% vs. 32.7%, P 〈 0.01）were significantly higher in post-acute myocardial infarction patients than that in healthy subjects. Plaque index （ 1.69±0.49 vs. 1.57±0.50, P = 0.22）, PD （2.88±1.02 vs. 2.64±0.68, P =0.09） were higher in post-acute myocardial infarction patients than that in healthy subjects, but not statistically significant. In the multivariate analysis, after adjusting sex, age, smoking, body mass index, diabetes, hypertension and serum lipid, AL I〉 4.00 mm was a significant risk indicator for post-acute myocardial infarction（ odd ratio 4.89, 95% confidence interval 1.26 to 18.94, P =0.02）. Conclusion： Periodontal status was worse in post-acute myocardial infarction patients than that in healthy subjects, AL≥4.00 mm was an indenendent risk indicator for oost-acute myocardial infarction.