RT-qPCR检测CPC对中重度慢性牙周炎患者口内环境中红色复合体的影响

Effect of Cetylpyridinium Chloride on Red Complex Bacteria in Moderate to Severe Chronic Periodontitis Patients by Real-time Quantitative PCR

目的:利用RT-qPCR检测CPC对中重度慢性牙周炎患者口内环境中红色复合体构成比的影响。方法:临床选择40例中重度慢性牙周炎患者,随机分成CPC(试验)组、溶媒(对照)组,牙周基础治疗后分别使用该药品含漱+袋内冲洗。记录患者基线和用药4周后的临床指标;采集龈下菌斑、龈沟液和唾液样本,BANA试验检测胰蛋白酶样酶含量,RT-qPCR检测P.gingivalis、T.forsythia、T.denticola在总菌量中的构成比。结果:治疗后:1)试验组AL、BOP、PLI显著改善(P<0.01),对照组仅AL改善(P<0.01);2)两组龈下菌斑和龈沟液样本中胰蛋白酶样酶含量均显著下降(P<0.05);3)两组P.gingivalis构成比均显著下降(P<0.01),T.forsythia在试验组构成比显著下降(P<0.01),而T.denticola治疗前后无变化;4)P.gingivalis、T.forsythia、T.denticola两两之间构成比均显著相关(P<0.01)。结论:CPC可抑制牙菌斑形成,改善患者的临床症状,并对龈下菌斑中的P.gingivalis有一定的抑制作用,临床上可用于辅助治疗中重度慢性牙周炎。

Objective： To determine the effect of CPC mouthwash on the proportions of red complex bacteria in patients with moderate to severe chronic periodontitis by RT-qPCR. Methods： Forty patients with periodontitis were randomly assigned to two groups： experimental group （SRP＋CPC） and control group （SRP＋ placebo）. Clinical parameters were recorded at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva samples were collected, and the content of trypsin-like enzyme was detected using BANA test. RT-qPCR was used to detect the proportions of P.gingivalis, T.forsythia and T.denticola in total bacteria. Results： AL, BOP, and PLI significantly improved （P〈0.01） after treatment in the experimental group. Only AL significantly improved in the control group （P〈0.01）. The level of trypsin-like enzyme in subgingival plaque and gingival crevicular fluid for both groups decreased significantly （P〈0.05）. The numbers of P. gingivalis decreased significantly in both groups （P〈0.01）, while T.forsythia decreased significantly in the experimental group （P〈0.01）. There was no significant difference in the numbers of T.denticola after treatment compared to baseline. There was a significant correlation between the proportions of P.gingivalis, T.forsythia, and T.denticola （P〈0.01）. Conclusion： CPC can inhibit plaque formation and improve clinical parameters in patients with moderate to severe chronic periodontitis, but has no significant inhibitory effect on P.gingivalis, T.forsythia, and T.denticola.