慢性牙周炎伴2型糖尿病患者牙周健康的影响因素分析

Influencing factors of periodontal health in patients with chronic periodontitis and type 2 diabetes mellitus

目的分析影响慢性牙周炎伴2型糖尿病患者牙周健康因素。方法随机选取2014年1月-2016年1月进行治疗的慢性牙周炎合并2型糖尿病患者共130例,对患者进行自制问卷调查,同时检查以上患者的缺牙数目、牙龈出血指数(gingival index,GI)、牙槽骨吸收水平、空腹血糖含量(fasting plasma glucose,FPG)和糖化血红蛋白(HbA1c)。结果刷牙次数≥2次/d的患者GI、FPG及HbAlc值均明显低于刷牙次数≤1次/d的患者(t=4.082,P<0.001;t=3.290,P=0.002;t=3.349,P=0.002);使用牙线患者的GI和牙槽骨吸收水平均明显低于不使用牙线的患者(t=3.104,P=0.002;t=4.292,P<0.001);不吸烟患者的牙槽骨吸收水平明显小于吸烟患者(t=2.977,P=0.003);患者的饮酒行为与其牙周健康无关(P>0.05)。线性回归分析表明刷牙次数≥2次/d和使用牙线是保护患者牙周健康和维持正常糖代谢水平的重要行为,而吸烟是其重要的危害因素。结论慢性牙周炎伴2型糖尿病患者的牙周健康和糖代谢水平与其刷牙习惯、牙线使用情况和吸烟情况具有相关性。

Objective To analyze the influencing [actors of the periodontal health of chronic periodontitis patients with type 2 diabetes mellitus. Methods Totally 130 patients with chronic periodontitis and type 2 diabetes and treated in our hospital between January 2014 and January 2016 were selected and investigated using a self-made questionnaire. At the same time, the number of missing teeth, gingival index （GI）, alveolar bone resorption （ABR）, fasting plasma glucose （FPG） and glycosylated hemoglobin （HbAlc） were recorded. Results The GI, FPG and HbAlc of patients brushing teeth no less than 2 times/d were significantly lower than those brushing their teeth no more than once a day （t=4. 082, P〈0. 001; t=3. 290, P=0. 002; t=3. 349, P=0. 002）. The GI and ABR of patients using dental floss were significantly lower than those not using （t = 3. 104, P = 0. 002; t = 4. 292, P 〈0. 001）. The ABR of non-smokers was significantly lower than that of smokers （t=2.977, P =0. 003） and the drinking behavior has nothing to do with the peridental health. Regression analysis showed that daily brushing of no less than twice and using the dental floss played an important role in protecting the dental health and maintaining the normal glycometabolism, while smoking was an important risking factor. Conclusion The periodontal health and glycometabolism of patients with chronic periodontitis and type 2 diabetes are closely related to their brushing habits, dental floss usage and smoking status.