牙周炎与慢性阻塞性肺疾病关系的流行病学研究

The epidemic study on the relationship between periodontitis and chronic obstructive pulmonary disease

目的通过流行病学调查及临床检查,探讨牙周炎与慢性阻塞性肺疾病(COPD)之间的相关性。方法收集中国医科大学附属第一医院、盛京医院、第四医院和沈阳市第八人民医院2008年10月至2009年4月确诊为COPD的患者266例,其中稳定期COPD患者160例,急性加重期COPD(AE-COPD)患者106例,检查并记录所有患者6颗指数牙(61 6、6 16)的简化口腔卫生指数(OHI-S)、龈沟出血指数(SBI)、牙周探诊深度(PD)、临床附着丧失(CAL),同时对所有患者进行肺功能指标的检查,并进行口腔问卷调查。结果 (1)AE-COPD组的吸烟率为47.2%,明显高于稳定期COPD组(P<0.01);(2)AE-COPD组的SBI、PD及CAL明显高于稳定期COPD组(P<0.01);(3)AE-COPD组的OHI-S、SBI、PD及CAL均与FEV1%呈负相关(r分别为-0.309、-0.333、-0.395、-0.702,均P<0.01),其中CAL与FEV1%的相关性最强;稳定期COPD组CAL与FEV1%呈负相关(r=-0.657,P<0.01)。结论(1)吸烟作为牙周炎和COPD的共同危险因素,在牙周炎和COPD的发生和发展中发挥重要作用;(2)AE-COPD患者的牙周炎症程度均随着肺功能的减弱而加重,提示牙周炎与COPD之间存在一定相关性。

Objective To explore the relationship between periodontitis and chronic obstructive pulmonary disease by analyzing the relationship between FEV1% and periodontal index. Methods Totally 160 cases of stable COPD and 106 cases of acute exacerbation of COPD were collected. Check and record simplified oral hygiene index, sulcus bleeding index, probing depth and clinical attachment loss of all six index teeth, use pulmonary function to test and record the FEV1%, and do oral survey for all subjects. Results （ 1 ）The smoking rate of AE-COPD group was 47.2%, which was higher than that of the stable COPD group （P 〈 0.01 ） ; （2）SB1, PD and CAL of AE-COPD group were significantly high- er than that of stable COPD group （P 〈 0.01 ） ; （3） OHI-S, SBI, PD and CAL of AE-COPD group showed a strong correlation with FEVI% （r = -0.309,P 〈 0.01 ;r = -0.333,P 〈 0.01 ;r = -0.395,P 〈 0.01 ;r = -0.702,P 〈 0.01） ;CAL of stable COPD group was correlated with FEVI% （r = -0.657,P 〈 0.01 ）. Conclusion （1）Smoking is a very important risk factor for periodontitis and COPD. （2）The degree of periodontal inflammation in AE-COPD patients aggravates with pulmonary function abating, which suggests there is a correlation between periodontitis and COPD.