2型糖尿病伴慢性牙周炎患者的血清学指标及意义

Clinical value of serum markers of type 2 diabetes mellitus complicated by chronic periodontitis

目的探讨2型糖尿病患者血清学指标与慢性牙周炎病损程度及进展期之间的关系。方法抽样选取595名2型糖尿病患者进行口腔和血清学检查,根据慢性牙周炎病损程度诊断标准将牙周健康的2型糖尿病患者设为对照组,伴慢性牙周炎患者分为轻度组、中度组和重度组;同时,根据慢性牙周炎病变进展期分为静止期组和活动期组。统计学分析各项血清学指标与慢性牙周炎病损程度及进展期的关系。结果纳入的2型糖尿病患者中慢性牙周炎患病率为74.6%,其中,轻、中、重度慢性牙周炎构成比分别为44.9%、16.1%、13.6%,活动期慢性牙周炎患者构成比为33.1%。相较于对照组,空腹血糖和糖化血红蛋白在2型糖尿病伴慢性牙周炎患者中控制欠佳(P<0.05);空腹血糖值在慢性牙周炎轻度组与中、重度组的比较有统计学意义(P<0.05);糖化血红蛋白在慢性牙周炎轻、中、重度组的组间差异无统计学意义(P>0.05)。慢性牙周炎不同进展期的组间比较中,空腹血糖值的变化具有统计学差异:慢性牙周炎活动期组(11.24±3.50)mmol/L>静止期组(9.64±3.42)mmol/L>对照组(8.82±3.08)mmol/L(P<0.05)。结论慢性牙周炎的病损程度与糖化血红蛋白水平无关;但空腹血糖水平会随慢性牙周炎严重程度及进展期的改变而发生相应变化。

Objective To investigate the relation between serum markers, the degree of lesions and the active period of chronic periodontitis in patients with type 2 diabetes mellitus. Methods A total of 595 patients with type 2 diabetes mellitus were selected, and oral examinations and laboratory tests were conducted. The patients were divided into a periodontally healthy group mild, moderate and severe periodontitis groups depending on the diagnostic criteria for chronic periodontitis. The patients were also divided into periodontally healthy, resting and active groups depending on the diagnostic criteria of the active period. The relationships between serum biochemical indices, the degree of lesions and chronic periodontitis activity were analyzed. Results The prevalence of chronic periodontitis in patients with type2 diabetes was 74.6%, and the proportions of patients with mild, moderate, and severe chronic periodontitis were44.9%, 16.1% and 13.6%, respectively. The composite ratio of active periodontal chronic periodontitis was 33.1%. Compared with the patients in the control group, the fasting plasma glucose and Hb A1 c levels were more poorly controlled in the type 2 diabetes mellitus groups with chronic periodontitis（P〈0.05）. There were significant differences in fasting blood glucose levels between mild periodontitis group and moderate, severe periodontitis group（P〈0.05）. There was no significant difference in Hb A1 c levels among the mild, moderate and severe groups（P〈0.05）. However, there were significant differences in fasting blood glucose levels between the groups with various degrees of progression in the following order： active（11.24 mmol/L） resting（9.64 mmol/L） control（8.82 mmol/L）（P〈0.05）. Conclusion The severity of chronic periodontitis plays no role in the level of Hb A1 c, instead, the level of fasting plasma glucose changes with the severity and progression of chronic periodontitis.