不良口腔卫生与动脉粥样硬化关系的初步探讨

Preliminary study on the relationship between poor oral hygiene and atherosclerosis

目的初步探讨不良口腔卫生与早期动脉粥样硬化（atherosclerosis,AS）的相关关系。方法选择2014年7月至2015年10月于山西省太原市中心医院心内科住院的202例冠心病患者,对入选者进行统一问卷调查,记录基本人口特征、口腔情况和AS的危险因素并进行常规生化检验。颈动脉超声检查记录颈动脉内中膜厚度（intima-media thickness,IMT）和斑块情况,将患者分为对照组（IMT〈1 mm且无动脉粥样硬化斑块）和病例组[IMT≥1 mm和（或）存在动脉粥样硬化斑块]。结果单因素分析显示,两组间年龄、牙石指数、刷牙频数和缺牙数目差异均具有统计学意义（P〈0.05）。多因素非条件Logistic回归分析显示,牙石指数（OR=1.864,95%CI：1.344～2.685,P〈0.001）和缺牙数目（OR=1.080,95%CI：1.041～1.212,P〈0.001）是IMT增厚和（或）存在AS斑块的危险因素。结论随着牙石指数增高和失牙数目增加,IMT增厚及AS斑块形成的风险升高。牙石指数和失牙数目可能是IMT增厚及AS斑块形成的有效风险指标。

ObjectiveTo evaluate the association between poor oral hygiene and early atherosclerosis.MethodsTotally 202 coronary heart disease（CHD）inpatients in the Central Hospital of Taiyuan,from July 2014 to October 2015,were involved in the study. Demographic characteristics,oral health status,atherosclerosis risk factors and routine biochemical tests were collected using a standardized questionnaire. Carotid intima-media thickness（IMT）and atherosclerotic plaques were measured by carotid ultrasonography. Patients were divided into two groups：the control group had IMT 1mm and absence of atherosclerotic plaques,and the test group had IMT≥1 mm or the presence of any carotid atherosclerotic plaque.ResultsOne-way analysis of variance showed that in age,calculus index,the frequency of teeth brushing and tooth loss,the differences between the two groups were statistically significant（P 0.05）.Multivariate unconditioned Logistic regression analysis showed that calculus index（OR = 1.864,95% CI：1.344～2.685,P 0.001）and tooth loss（OR = 1.080,95%CI：1.041～1.212,P 0.001）were risk factors of IMT or presence of any carotid atherosclerotic plaque.ConclusionAs calculus index and tooth loss increase,the risk of IMT thickening and atherosclerotic plaques formation increase. Calculus index and tooth loss may be the efficient risk factors of IMT thickening and atherosclerotic plaques formation.