不同HbA1c水平2型糖尿病患者牙周炎状况分析

Clinical analysis of periodontitis in type Ⅱ diabetes patients with different hbA1c levels

目的:对比分析不同糖化血红蛋白(HbA1c)水平2型糖尿病患者的血尿酸、龈沟液炎症因子含量与牙周炎的关系。方法:纳入2型糖尿病合并慢性牙周病患者90例,根据HbA1c水平分为3组(n=30),A组:HbA1c<7.5%;B组:HbA1c在7.5%~9%;C组:HbA1c≥9%。另选血糖、牙周均健康的体检者30例为对照组。对所有受检者均进行血尿酸、龈沟液炎症因子IL-1、TNF-α的检测及牙周状况的检查,并进行统计分析。结果:A、B、C组的血尿酸水平及龈沟液中IL-1、TNF-α含量均高于对照组,随着HbA1c水平的升高,3组患者龈沟液中IL-1、TNF-α含量也逐渐增高,C组>B组>A组(P<0.05);血尿酸水平也有所增加,B、C组高于A组(P<0.05),B组与C组无统计学差异(P>0.05);B、C组PLI、GI、PD以及CAL均高于A组和对照组(P<0.05);A组与对照组差异无统计学意义(P>0.05)。结论:血尿酸及龈沟液中IL-1、TNF-α与2型糖尿病患者牙周炎发生发展密切相关,2型糖尿病患者牙周炎发生率、发生严重程度与HbA1c水平亦相关。当HbA1c≥7.5%时,牙周炎损害的程度均显著增高。

AIM To study the relation of HbAlc,serum uric acid（SUA） and inflammatory factors in gingi-val crevicular fluid（GCF） with type 2 diabetes and chronic periodontitis. METHODS： 90 patientis with type 2 diabe-tes mellitus and chronic periodontitis were divided into 3 groups （ n = 30） according to the HbAlc level, group A： HbAlc〈7.5%; GroupB： HbAlc between 7. 5% and 9% ; Group C ： HbAlc ≥ 9%. 30 cases of healthy subjects were included in the control group. SUA, IL - 1 and TNF -α in GCF and periodontal indexes in all subjects were measured. Data were statisticaly analysed . RESULTS ： The content of SUA, IL - 1 and TNF -α in group A , B and C was higher than that in control group. The concentration of IL - 1 and TNF -α increased with the increase of HbAlc level（ groupC 〉 groupB 〉 groupA, P 〈 0. 05 ） . The concentration of SUA increased with the increase of HbAlc level （between group A and B or C, P 〈0. 05 ; between group B and C （P 〉0. 05） . PLI, GI, PD and CAL in group B and C were higher than those in group A and the control （ P 〈 0. 05 ; between group A and the control P 〉 0. 05 ） . CONCLUSION ：The increase of SUA and IL - 1 and TNF -α in GCF is the important factors for the development and pro-gression of periodontitis in type 2 diabetes mellitus patients. The severity of periodontitis in patients with type 2 diabetes is closely related to HbAlc level.