糖尿病儿童唾液中龋病和牙周病相关因子的研究

The salivary factors related to caries and periodontal disease in children and adolescents with diabetes mellitus

目的通过检测糖尿病儿童唾液中龋病和牙周病相关因子，探讨患糖尿病对儿童患龋病与牙周病危险性的影响。方法选择30例7至15岁糖尿病儿童（糖尿病组）和60名性别、年龄与之匹配的健康儿童（健康对照组），检查记录两组的龋齿和牙周情况，重点检测唾液中与龋病和牙周疾病的相关因子。结果糖尿病组儿童恒牙和乳牙的龋失补牙数[M（Q1，Q3）]分别为0（0，4）、0（0，1），与健康对照组恒牙和乳牙的龋失补牙数[分别为1（0，3）、0（0，4）]相比差异均无统计学意义（P〉0．05）；菌斑指数（1．25±0．33）和牙龈出血指数（0．74±0．45）均显著高于健康对照组（菌斑指数和出血指数分别为0．93±0．31、0．34±0．22）（P〈0．001）；唾液pH值（7．68±0．36）显著高于健康对照组（7．30±0．32）（P〈0．05）；两组儿童唾液对酸的缓冲能力、唾液葡萄糖浓度、免疫球蛋白sIgA和sIgG水平差异均无统计学意义（P〉0．05）。糖尿病组儿童唾液溶菌酶含量[（68．45±8．99）mg／L]显著高于健康对照组[（59．65±7．41）mg／L]（P〈0．05）；总蛋白水平[（3．26±0．79）g／L]显著低于健康对照组[（3．84±0．46）g／L]（P〈0．05）；两组唾液中乳酸脱氢酶含量差异无统计学意义（P〉0．05）。结论糖尿病导致儿童唾液中多种与牙龈炎相关的致病因子发生变化，提示糖尿病可能增加了儿童患牙周疾病的风险。

Objective To detect the salivary factors related to caries and periodontal disease and to analyze the risk of caries and periodontal disease in children and adolescents with diabetes mellitus. Methods The study comprised 30 children with diabetic mellitus, aged 7-15 years old ,and 60 healthy age-and gender- matched children. Caries and periodontal indexes were recorded and saliva related factors were analyzed. Results Caries indexes of diabetes children[ permanent teeth：decay missing filling tooth（DMFT） M（ Q1, Q3 ） = 0 （ 0,4 ）, deciduous teeth ： decay missing filling tooth （dmft） M （ Q1, Q3 ） = 0 （ 0, 1 ） ] were not significantly different with those of healthy children [ DMFT M （ Q 1, Q3 ） = 1 （0,3）, draft M （ Q1, Q3 ） = 0 （0,4） ], but plaque index （ PLI ） （ 1.25 ± 0. 33 ） and bleeding index （ BI ） （ 0. 74 ± 0. 45 ） of diabetes children were significantly higher than those of healthy children（PLI was 0. 93 ±0. 31 ,BI was 0. 34 ±0. 22） （P 〈0. 001 ）. Salivary pH of diabetes children（7.68 ± 0. 36 ） was significantly higher than that of healthy children （7.30 _± 0. 32）（P 〈0. 05 ） ,and salivary acid buffering capacity had no significant difference between the two groups （ P 〉 0.05 ）. Salivary glucose, immunoglobulin sIgA and sIgG were not significantly different between the two groups（ P 〉 0. 05 ） . Salivary lysozyme of diabetes children was significantly higher than that of healthy children（ P 〈 0. 05 ）. Total protein was significantly lower in diabetes children than in healthy children （P 〈 0. 05 ）. Salivary lactate dehydrogenase had no significant difference between the two groups （ P 〉 0. 05 ）. Conclusions Diabetes mellitus can lead to the changes of some salivary factors related to gingivitis in diabetes children. Children and adolescents with diabetes mellitus may have a higher risk of periodontal disease.