吸烟对慢性牙周炎老年患者病情进展和复发的影响

Influence of smoking on disease progression and relapse in elderly patients with chronic periodontitis

目的：探究吸烟对慢性牙周炎老年患者病情进展和复发的影响。方法选取2012年1月至2014年1月南京大学医学院附属口腔医院收治的50例慢性牙周炎患者，其中吸烟者25例作为观察组，不吸烟者25例作为对照组。抽取50例患者前臂静脉血5 mL 并离心提取血清，于血清中分别加入吸烟个体和非吸烟个体的血清200、400、800μL 至牙龈卟啉单胞菌（Pg）感染 KB 细胞模型，作用12 h 后，使用脑心浸液琼脂培养基对细菌进行5～7 d 的培养，计数细菌菌落。使用人酶联免疫吸附测定（ELISA ）试剂盒对2组患者上清液中的基质金属蛋白酶（MM P）‐1、MM P‐9和金属蛋白酶组织抑制剂‐1（TIMP‐1）的浓度差异进行测定。对2组血清中分别加入不同体积血清对 Pg 内化 KB 细胞的影响和 KB 细胞分泌 MMP‐1、MMP‐9、TIMP‐1的差异进行分析。比较2组血清中加入相同血清量 Pg 内化 KB 细胞及 KB 细胞分泌 MMP‐1、MMP‐9、TIMP‐1浓度的差异。结果加入不同体积的血清后对照组个体血清 Pg 内化 KB 细胞的菌落数均明显小于吸烟组，差异有统计学意义（P ＜0．05）。2组个体血清加入不同体积血清 Pg 内化 KB 细胞的菌落数差异均有统计学意义（P ＜0．05）。随着吸烟组血清剂量的增加，KB 细胞表达 MMP‐1、MMP‐9、TIMP‐1的质量浓度增加，不同体积的血清引起 MMP‐1、MMP‐9、TIMP‐1表达的差异均有统计学意义（P ＜0．05）。当加入800μL 吸烟组血清与加入800μL 非吸烟组血清比较，KB 细胞分泌 MMP‐1、MMP‐9、TIMP‐1的质量浓度均明显升高（P＜0．05），差异有统计学意义。结论吸烟个体的血清能够促进 Pg 内化 KB 细胞产生 MMP‐1、MMP‐9、TIM P‐1，促进慢性牙周炎的进展和复发。

Objective To investigate the influence of smoking on disease progression and recurrence in elderly patients with chronic periodontitis .Methods 50 cases of chronic periodontitis patient in our hospital from January 2012 to January 2014 were selected ,among them 25 cases of smoking were taken as the observation group and 25 ca‐ses of non‐smoking as the control group .5mL of forearm blood was collected in 50 patients and centrifuged for ex‐tracting serum .The serum 200 ,400 ,800 μL in smoking individual and non‐smoking individuals were added to porphy‐romonas gingivalis（Pg） infecting the KB cell model ,after 12 h action ,the brain heart infusion agar medium was used for conducting 5 - 7 d bacterial culturing and the bacterial colonies were counted .The human enzyme‐linked immu‐nosorbent assay（ELISA） kit was used to detect the concentration differences of matrix metalloproteinases（MMP）‐1 , MMP‐9 and tissue inhibitor of metalloproteinase 1 （TIMP‐1） in the supernatant of two groups .The influence of adding different volumes of serum on the Pg internalizing KB cells and the differences of KB cells secreting MMP‐1 , MMP‐9 and TIMP‐1 were analyzed .In adding the same volume of serum ,Pg internalizing KB cells and difference of KB cells secreting MM P‐1 ,MMP‐9 and TIMP‐1 were compared between the two groups .Results After adding dif‐ferent volumes of serum ,the colonies of Pg internalizing KB cells in control group individual serum were significantly less than those in the smoking group ,the difference was statistically significant（P〈 0 .05） .In adding different vol‐umes of serum in the two groups individual serum ,the difference of colonies number of Pg internalizing KB cells were statistically significant（P〈 0 .05） .With increasing doses of serum in the smoking group ,KB cells expressed MMP‐1 , MMP‐9 and TIMP‐1 concentrations were increased ,the MM P‐1 ,MMP‐9 and TIMP‐1 expression differences caused by different volumes of serum were statistically significance（P〈0 .05） .Comparing adding 800 μL of smoking group serum with 800 μL of non‐smoking group serum ,KB cells secreting MMP‐1 ,MMP‐9 and TIMP‐1 concentrations were significantly increased（P〈 0 .05） .Conclusion Smoking individual serum can contribute to Pg internalizing KB cells to produce MM P‐1 ,MMP‐9 and TIMP‐1 ,thus promote the progression and recurrence of chronic periodontitis .