牙周基础治疗对脑卒中高危人群伴中重度牙周炎患者血清sCD40L及牙周临床指标的影响

Effects of essential periodontal treatment on serum level of s CD40L and periodontal clinical parameters in patients with moderate to severe periodontitis at high risk of stroke

目的:观察脑卒中高危人群伴中重度牙周炎患者治疗前、后血清可溶性白细胞分化抗原配体(soluble CD40ligand,sCD40L)水平的变化,探讨牙周基础治疗对脑卒中高危人群伴中重度牙周炎患者的影响。方法:收集脑卒中高危人群伴中重度牙周炎患者76例,随机分为2组。A组40例,接受牙周基础治疗+相应的常规维持治疗;B组36例,仅接受常规维持治疗。另选取单纯中重度牙周炎患者36例,设为C组,接受牙周基础治疗。分别在治疗前和治疗后3个月由同一名口腔医师检查全口牙6个位点的探诊出血(bleeding on probing,BOP)、牙周探诊深度(probing depth,PD)、附着丧失(attachment loss,AL),用酶联免疫吸附反应法(ELISA)检测血清sCD40L水平。采用SPSS17.0软件包对数据进行统计学分析。结果:与治疗前相比,3组患者血清sCD40L水平及牙周临床指标均下降;与B组相比,A组下降更加明显,具有显著差异(P<0.05)。结论:牙周基础治疗能降低脑卒中高危人群伴中重度牙周炎患者血清sCD40L水平,改善机体的炎症状态,在一定程度上降低脑卒中高危人群向脑卒中发展的风险。

PURPOSE： To investigate the effect of periodontal treatment on patients with moderate to severe periodontitis at high risk of stroke, by detecting the level of serum soluble cell differentiation antigen 40 ligand （sCD40L） before and after periodontal non-surgical treatment. METHODS： Seventy-six patients with moderate to severe periodontitis at high risk of stroke were collected and randomly divided into 2 groups, 40 patients in group A received essential periodontal treatment ＋ routine maintenance therapy, 36 cases in group B only received routine maintenance therapy. Another 36 patients with moderate and severe periodontitis were selected as group C, and received essential periodontal treatment. Bleeding on probing （BOP）, periodontal probing depth （PD） and attachment loss （AL） in 6 loci were examined by the same dentists, and enzyme linked immunosorbent assay （ELISA） was used to detect the level of serum sCD40L before treatment and 3 months after treatment. The data were analyzed by SPSS 17.0 software package. RESULTS： Compared with pre-treatment, serum level of sCD40L and periodontal clinical indexes of the three groups decreased. Compared with group B, serum SCD40L in group A significantly decreased（P〈0.05）. CONCLUSIONS： Periodontal treatment can reduce the serum level of sCD40L in patients with moderate to severe periodontitis at high risk of stroke, and improve the patient＇s inflammatory state. To a certain extent, periodontal treatment may reduce the risk of high-risk stroke population to develop stroke.