慢性牙周炎患者龈沟液中ON、IL-18和IL-23测定及其临床评价

The Determination and Clinical Evaluation of Changes on Gingival Crevicular Fluid ON,IL-18 and IL-23 Levels in Patients with Chronic Periodontitis

目的:探讨慢性牙周炎(chronic periodontitis,CP)患者龈沟液(gingival crevicular fluid,GCF)中骨黏连蛋白(osteoneetin,ON)、白细胞介素-18(interleukin-18,IL-18)和IL-23测定意义及临床价值。方法:选择30例CP患者分别设置为治疗前、规范牙周基础治疗4周及治疗8周三组进行围治疗期分组测定分析。ON、IL-18和IL-23测定均采用酶联免疫吸附试验(ELISA)。结果:CP患者治疗前患牙临床检查记录数据显示,牙周袋深度(PD)、附着丧失(AL)和龈沟出血指数(SBI)都显著高于对照组(P均<0.01),治疗4周三项临床指标明显下降,但仍显著高于对照组(P均<0.05),治疗8周后前二项临床指标仍显著高于对照组(P均<0.05),仅SBI已恢复至正常人水平(P>0.05)。GCF中炎性指标结果显示,治疗前三项炎性因子水平均显著高于对照组(P均<0.01),治疗4周三项临床指标明显下降,IL-18和IL-23已恢复至正常人水平(P均>0.05),但ON仍显著高于对照组(P<0.05);治疗8周三项临床指标均恢复至正常人水平(P均>0.05)。炎性指标与临床指标的相关性分析结果显示,ON与IL-18、IL-23呈微弱相关(r=0.546、0.502,P<0.06、P<0.05),而与PD、AL和SBI呈显著正相关,尤以PD、AL为甚(r=0.602、0.560、0.813,P<0.05、P<0.05、P<0.05)。IL-18与PD、AL、SBI呈显著正相关,且相关性甚以ON与之(r=0.602、0.560、0.813,P<0.05、P<0.05、P<0.05);IL-23与PD、AL、SBI也呈显著正相关(r=0.703、0.631、0.828,P<0.05、P<0.05、P<0.05)。结论:患者GCF中炎性指标参与了CP的病理进展过程,其测定对于了解本病的病理进展机制和炎症反应的评估提供一定的帮助。

Objective To explore the changes of gingival crevicular fluid ON,IL-18 and IL-23 levels in patients with chronic pe-riodontitis and the clinical value of the determinations. Methods According to before and after treatment in different time points there were divided 3 groups ：before treatment group（ n = 30）, after 4 weeks of treatment group（ n = 30） and after 8 weeks of treatment group （n = 30）. Their gingival crevicurlar fluid levels of ON, IL-18and IL-23 were determined with ELISA in30 patients with chronic peri- odontitis and 30 healthy persons served as normal control group. Results Table 1 shows, before treatment group 3 dental clinic record were all presented significantly higher than those in controls （ all P 〈 0.01 ）, after 4 weeks of treatment the 3 indicators were significantly decreased, but the level were still significantly higher in 30 patients with CP than the controls （ all P 〈 0.05）, after 8 weeks of treatment the 3 indexes showed deline further, but the former 2 indexes were still higher in patient group than that of controls （ all P 〈 0.05 ）. Ta- ble 2 shows, before treatment 3 indexes all proved apparently higher than the controls（ all P 〈 0.01 ）, after 4 weeks of treatment the 3 indicators were significantly decreased, but the ON level still higher in patients group than that in controls （P 〈 0.05）, after 8 weeks of treatment the 3 indexes were decline further, and indicated no significant difference than the controls （ all P 〉 0.05）. Table 3 the result of correlative analysis shows, ON with IL-18 and IL-23 correlative analysis results presented weak correlation（ r = 0.546, 0.502 ,P = 0.048, P 〈 0.05 ）, and with PD, AL and SBI showed positive correlation, especially more significant with the former two （ r = 0.687, 0. 702 ,0. 501, P 〈 0.05, P 〈 0.05, P 〈 0.05 ） .IL-18 with PD, AL and SBI showed all positive correlation （ r = 0. 602 ,0. 560 ,0. 813 , P 〈 0.05, P 〈 0.05,P 〈 0.05 ）. IL-23 with PD, AL and SBI proved positive correlation （ r = 0. 703 ,0. 631, 0. 828,P 〈 0.05, P 〈 0.05, P 〈0.05）. Conclusion The changes on gingival crevicular fluid levels of ON , IL-18 and IL-23 corporating with the pathological process; and could be used for the understanding of its pathogenesis and periodontal tissue inflammation.