2型糖尿病合并牙周病患者氧化应激损伤和炎症标志物的临床研究

Clinical analysis of oxidative stress damage and inflammatory markers in patients with type 2 diabetes and periodontitis

目的探讨2型糖尿病合并牙周病患者氧化应激和炎症标志物的水平及其与牙周病变损伤的相关性。方法选取2型糖尿病合并牙周病患者170例(按照血糖控制良好、不佳分为A、B组),无2型糖尿病的牙周病患者98例(C组),测量牙周袋探诊深度(PD)及附着丧失(AL),测定超氧化物歧化酶(SOD)及丙二醛(MDA)水平,ELISA法检测龈沟液中TNF-α、IL-6浓度。结果 A、B、C3组AL、PD、IL-6、TNF-α、MDA水平依次降低,SOD依次升高,血清MDA分别与HbA1c、AL、PD、IL-6、TNF-α呈显著正相关,与SOD呈负相关,影响MDA的主要因素有HbA1c、AL、PD、IL-6及TNF-α。结论 2型糖尿病合并牙周病,尤其是血糖控制不佳者受到氧化应激损伤,并加重牙周局部炎症反应。

[Objective] To investigative the levels of oxidative stress damage and inflammatory markers in patients with type 2 diabetes and periodontitis, and to analysze the correlation of the markers with periodontal condition. [Methods] 170 patients with type 2 diabetic and periodontitis were selected and divided into 2 different groups according to their HbAlc levels. Their were well-controlled group （A group） and uncontrolled group （B group）. Other 98 periodontitis patients without diabetes were the control group （C group）. Their probing depth （PD）, attachment loss （AL）, the levels of SOD , MDA and the values of TNF-α, IL-6 in the gingival crevicular fluid were assessed. [Results] In A, B, C group, SOD increased when AL, PD, IL-6, TNF-α, MDA decreased. MDA had a positive correlation with HbAlc, AL, PD, IL-6, TNF-α, and a negative correlation with SOD. HbAlc, AL, PD, IL-6, TNF-α were main influencing factors of MDA. [Conclusion] Patients with type 2 diabetes and periodontitis, particularly poorly controlled diabetics, have been subjected to oxidative stress injury which activates the inflammatory response.