牙周基础治疗对慢性牙周炎伴2型糖尿病患者炎症反应及糖代谢的影响

Analysis of the level of inflammatory cytokines and glycosylated hemoglobin in patients with chronic periodontitis complicated with type 2 diabetes mellitus

目的评估牙周基础治疗对慢性牙周炎伴2型糖尿病患者炎症反应及糖代谢的影响。方法选择2011年7月-2014年7月来我院牙周科就诊患者213例,其中单纯慢性牙周炎患者102例(观察组),2型糖尿病伴慢性牙周炎患者111例(试验组);另从体检中心牙周健康人群中选择30名作为对照组。检查基线水平和牙周基础治疗后3个月各组的牙周状况,检测血清炎性细胞因子(CRP、TNF-α及IL-6)和HbA1c含量。结果治疗前,试验组和观察组的PD、CAL及SBI值及血清炎性细胞因子(CRP、TNF-α及IL-6)含量均高于对照组,差异有统计学意义(P<0.05)。治疗3个月后,试验组和观察组的PD、CAL及SBI值与治疗前比较均有所减小,差异有统计学意义(P<0.05)。治疗3个月后,试验组和观察组的CRP、TNF-α及IL-6含量与治疗前比较均明显下降,差异有统计学意义(P<0.05);治疗前,试验组的HbA1c含量明显高于观察组和对照组;治疗3个月后,试验组的HbA1c含量显著下降,且其治疗前后差异有统计学意义(P<0.05)。结论牙周基础治疗可有效改善牙周病伴2型糖尿病患者的牙周健康状况,降低血清中炎性细胞因子水平,并可在一定程度上改善代谢状况。

【Objective】To investigate the relationship between inflammatory cytokines and periodontal inflammation before and after periodontal treatment and discuss whether periodontal treatment could improve the level of glycosylated hemoglobin in patients with chronic periodontitis complicated with type 2 diabetes mellitus（T2DM）by reducing the level of inflammatory cytokines. 【Methods】Totally 213 patients with chronic periodontitis were chosen from July 2011 to July 2014 in Yangjiang People＇s Hospital of whom there were 111 patients with T2DM（experimental group）and 102 patients with only chronic periodontitis（observation group）30 periodontal healthy individuals were chosen from Medical Center as the normal control group.Prior to periodontal treatment and for 3 months after treatment,determine periodontal status of each group and serum inflammatory cytokines（CRP、TNF-α 及 IL-6） and glycosylated hemoglobin（Hb A1c）levels,and make comparative analysis of the test results. 【Results】Periodontal treatment could improve the periodontal health in patients with periodontitis and reduce the level of inflammatory cytokines.Serum inflammatory cytokines CRP, TNF-α and IL-6 levels of experimental group and observation group after periodontal therapy for 3 months were significantly decreased. the difference being statistically significant（P〈0.05）.【Conclusion】For T2 DM patients with chronic periodontitis,periodontal treatment can improve periodontal status and general health of the patient,thereby reduce the OC-currence and development of diabetes and its complications.