慢性牙周炎合并糖尿病患者唾液及龈下菌斑中牙周致病菌检测临床研究

Clinical study on detection of periodontal pathogens in saliva and gingival crevicular fluid of patients with chronic periodontitis complicated with diabetes mellitus

目的探讨慢性牙周炎(CP)合并2型糖尿病(T2DM)患者与单纯CP患者唾液及龈下菌斑中牙周致病菌的差异性。方法选择河南大学第一附属医院口腔科2012年8月至2015年9月伴T2DM的CP患者40例为CP+T2DM组,同时选取背景相似的慢性CP患者65例为CP组,并选取健康体检者35名作为对照组,采用聚合酶链反应(PCR)检测各组受试者唾液及龈下菌斑中牙龈卟啉单胞菌(Pg)、放线共生放线杆菌(Aa)、具核梭杆菌(Fn)、福塞坦菌(Tf)、中间型普里沃菌(Pi)、齿垢密螺旋体(Td)等可疑致病菌种类和相对含量。结果 3组受试者唾液及龈下菌斑中Pg、Aa和Tf检出率比较差异有统计学意义(P<0.05),而Fn、Pi和Td检出率差异无统计学意义(P>0.05),3组受试者唾液及龈下菌斑中Fn检出率均最高,CP+T2DM组唾液及龈下菌斑中Pg、Aa、Tf检出率均显著高于对照组和CP组(P<0.05),而CP组仅Pg检出率显著高于对照组(P<0.05),CP+T2DM组和CP组唾液及龈下菌斑中Pg、Aa和Tf相对含量均显著高于对照组(P<0.05),且CP+T2DM组唾液及龈下菌斑中Aa和Tf相对含量显著高于CP组,差异有统计学意义(P<0.05)。结论 CP患者和伴糖尿病的CP患者牙周可疑致病菌的种类和数量存在明显差异,CP+T2DM组患者Pg、Aa和Tf检出率更高,可能与糖尿病关系更为密切。

Objective To investigate the differences in detection results of periodontal pathogens in saliva and gingival crevicular fluid between patients with chronic periodontitis（CP）and those complicated with diabetes mellitus（DM）.Methods Of the patients treated in the First Affiliated Hospital of Henan University between Aug. 2012 and Sep. 2015,40 cases of patients with CP complicated with T2 DM were selected as CP＋T2DM group,65 cases of patients with simple CP were selected as CP group,and 35 cases of healthy subjects were selected as the control group. The kinds and relative contents of suspected pathogens,such as Porphyromonas gingivalis（Pg）,Actinobacillus actinomycetemcomitans（Aa）,Fusobacterium nucleatum（Fn）,Tannerella forsythia（Tf）,intermediate type Prevotella intermedia（Pi）and Treponema denticola（Td）,in saliva and gingival crevicular fluid were detected by polymerase chain reaction（PCR）. Results The detection rates of Pg,Aa and Tf in the saliva and gingival crevicular fluid showed statistically significant differences among the three groups（P〈0.05）,but there were no significant differences in the detection rates of Fn,Pi or Td（P〈0.05）.The detection rate of Fn in saliva and gingival crevicular fluid of the three groups was the highest,and the detection rates of Pg,Aa and Tf in saliva and gingival crevicular fluid of CP ＋T2DM group were significantly higher than those in control group and CP group（P〈0.05）. The detection rate of Pg in CP group was significantly higher than that in the control group（P〈0.05）. The relative contents of Pg,Aa and Tf in the saliva and gingival crevicular fluid of CP＋T2DM group and CP group were significantly higher than those in the control group（P〈0.05）. The relative contents of Aa and Tf in saliva and gingival crevicular fluid of CP ＋ T2DM group were significantly higher than those in CP group（P〈0.05）. Conclusion There are significant differences in the types and number of suspected pathogens between patients with simple CP and those with CP and DM. Pg,Aa and Tf have more advantages in patients with DM,which may be closely related to DM.