口腔健康教育对维持性血液透析患者微炎症状态的影响

Effect of oral health education on micro- inflammatory state in maintenance hemodialysis patients

目的探讨口腔健康教育对维持性血液透析患者微炎症的影响。方法 80例患者随机分为治疗组40例,对照组40例,治疗组行口腔健康教育3个月,对照组未行口腔健康教育。观察两组患者口腔健康状况和微炎症状态的变化。结果治疗组经口腔健康教育3个月后牙龈出血指数(SBI)、菌斑指数(PLI)、牙龈指数(GI)和血清中肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)水平均较干预前低[SBI,2.35±0.88比2.83±0.71(t=2.684,P=0.009);PLI,1.63±0.46比1.99±0.51(t=3.323,P=0.001);GI,1.49±0.39比1.88±0.41(t=3.289,P=0.002);TNF-α,5.72±1.68 ng/L比6.60±2.01 ng/L(t=2.123,P=0.037);hs-CRP,30.36±9.25 mg/L比38.12±12.59 mg/L(t=3.141,P=0.002)],而对照组患者SBI、PLI、GI的指数和TNF-α、hs-CRP水平的干预前后的比较无差别(P>0.05)。结论口腔健康教育可改善维持性血液透析患者微炎症状态,应重视对维持性血液透析患者口腔健康教育。

Objective To explore the effect of oral health education on micro-inflammatory state in main- tenance hemodialysis （MHD） patients. Methods Eighty patients were randomly divided into the treatment group （n=40） or the control group （n=40）. Oral health education was carried on for 3 months in patients in the treatment group but not in those in the control group. Oral health condition and micro-inflammatory state were then observed in the two groups of MHD patients. Results Gingival bleeding index （SBI）, plaque in- dex （PLI）, gingival index （GI）, and serum TNF-ct and hs-CRP decreased in the treatment group after oral health education for 3 months （2.35±0.88 vs. 2.83±0.71, t=-2.684, P=0.009 for SBI; 1.63±0.46 vs. 1.99±0.51, t=-3.323, P=0.001 for PLI; 1.49i0.39 vs. 1.884-0.41, t：3.289, P=0.002 for GI; 5.72±51.68 ng/L vs. 6.60±2.01 ng/L, t=2.123, P=-0.037 for TNF-ct; 30.36±9.25 mg/L vs. 38.12±12.59 rag/L, t=3.141, P=0.002 for hs-CRP）. These indices were unchanged in the control group （P〉0.05）. Conclusion Oral health education could alle- viate micro-inflammatory state in MHD patients. Therefore, oral health education should be considered as an important measure in these patients.