糖皮质激素与龋病相关性的研究

The correlation between glucocorticoid and caries

目的:分析服用糖皮质激素(GC)前后唾液乳酸脱氢酶(LDH)、免疫球蛋白A(Ig A)和溶菌酶(LZM)、牙齿硬组织平均灰度值(MGVs)及患龋指数,探讨与龋病相关性。方法:收集试验组30例患者服用GC前、服用6个月、12个月后混合唾液,测LDH、Ig A和LZM以及拍摄全景片测牙齿硬组织MGVs,测龋病指数(CSI)。对照组30例性别、年龄与试验组相匹配的健康志愿者不用药,在相应时间进行同样的检测。用SPSS 17.0统计分析数据。结果:试验组用GC后,LZM、Ig A及牙齿硬组织MGVs低于对照组(P<0.05),LDH、龋失补牙数(DMFT)、龋失补牙面数(DMFS)、龋病指数(CSI)升高(P<0.05)。牙齿硬组织MGVs与DMFT、DMFS、CSI显著负相关(P<0.01),LDH与CSI显著正相关(P<0.01);LZM、Ig A与CSI负相关(P<0.05)。对照组各项指标无上述变化。结论:服用GC后DMFT、DMFS、CSI显著上升,牙齿硬组织MGVs显著降低,患龋风险增加。

Objective： To observe the changes of salivary Lysozyme（ LZM）,immunoglobulin A（ Ig A）,lactate dehydrogenase（ LDH）,mean grey values（ MGVs） of hard tissue of teeth and caries index（ CSI） in patients after oral administration of glucocorticoid（ GC）. Methods： 30 patients with oral administration of GC were included. The mixed saliva samples before and after 6 and 12 months of GC treatment were collected. LZM and Ig A and LDH were examined. Surface layer panaorama films were taken and MGVs of hard tissue of teeth were measured. The decayed,missing and filled tooth（ DMFT）,decayed,missing and filled surface（ DMFS）,CSI were recorded. The same indexes were obtained from 30 age and gender matched healthy subjects as the control data. All statistical analyses were performed using SPSS 17. 0 software package. Results： After taking GC orally,the concentration of LZM,Ig A and MGVs of hard tissue of teeth in the patients were lower than those in the controls（ P〈0. 05）,the LDH concentration,DMFT,DMFS and CSI in the patients were increased（ P〈0. 05）. In the patients the MGVs of hard tissue of teeth was negatively correlated with DMFT,DMFS and CSI（ P〈0. 01）,LDH concentration was positively correlated with CSI（ P〈0. 01）,the concentration of LZM and Ig A were negatively correlated with CSI（ P〈0. 05）. No change of the indexes was found in the controls. Conclusion： Oral administration of GC may increase DMFT,DMFS and CSI,decrease MGVs of hard tissue of teeth significantly reduce,the patients may be under higher risk of caries.