牙周基础治疗对非酒精性脂肪性肝病伴牙周炎患者肝功能及血脂水平的影响

Effect of periodontal basic treatment on liver function and lipid levels in periodontitis patients with non-alcoholic fatty liver disease

目的评估牙周基础治疗对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)伴牙周炎患者肝功能及血脂的影响。方法选择2018年7月—2019年6月杭州师范大学附属医院牙周科就诊的30例NAFLD伴中重度牙周炎患者,对入组患者进行牙周基础治疗,在治疗前和治疗后3个月分别对牙周临床指标、肝功能水平及血脂进行检测,治疗前后的数据对比采用配对t检验。结果与牙周基础治疗前相比,治疗后3个月牙周探诊深度从(3.76±0.46)mm下降至(2.30±0.37)mm,临床附着水平从(4.90±0.48)mm下降至(3.90±0.49)mm,全口探诊出血位点百分比从(88.93±5.05)%下降至(20.47±5.98)%;同时,丙氨酸氨基转移酶从(61.60±12.07)U/L下降至(45.82±11.82)U/L,天冬氨酸氨基转移酶从(54.71±11.20)U/L下降至(44.87±11.36)U/L;此外,总胆固醇从(5.63±0.24)mmol/L降低为(5.23±0.24)mmol/L,三酰甘油从(1.90±0.10)mmol/L下降至(1.63±0.13)mmol/L,低密度脂蛋白从(2.78±0.30)mmol/L降至(1.78±0.43)mmol/L,高密度脂蛋白从(1.25±0.05)mmol/L升高至(1.39±0.06)mmol/L,治疗前后差异均有统计学意义(均P<0.001)。结论 NAFLD伴牙周炎患者经过牙周基础治疗可获得良好的临床疗效,不仅牙周状态明显好转,同时也改善了患者的肝功能和血脂水平,牙周基础治疗可能是NAFLD伴牙周炎患者的治疗管理途径之一。

Objective To evaluate the effects of periodontal basic treatment on liver function and lipid levels in periodontitis patients with non-alcoholic fatty liver disease(NAFLD).Methods Thirty moderate or severe periodontitis cases with NAFLD were selected from July 2018 to June 2019 in Department of Periodontics,Affiliated Hospital of Hangzhou Normal University.All enrolled patients were treated with periodontal basic treatment.Periodontal clinical index,lipid levels and liver function examination were determined at baseline and 3 months after treatment.Paired t test was used to compare the data.Results Compared with periodontal basic treatment,the periodontal probing depth decreased from(3.76-±0.46)mm to(2.30±0.37)mm,the clinical attachment level decreased from(4.90±0.48)mm to(3.90±0.49)mm,and the percentage of bleeding on prohing decreased from(88.93±5.05)%to(20.47±5.98)%.Mean-while,the alanine aminotransferase decreased from(61.60±12.07)U/L to(45.82±11.82)U/L,and the aspartate aminotransferase decreased from(54.71±11.20)U/L to(44.87±11.36)U/L.In addition,total cholesterol reduced from(5.63±0.24)mmol/L to(5.23±0.24)mmol/L,triacylglycerol decreased from(1.90±0.10)mmol/L to(1.63±0.13)mmol/L,low-density lipoprotein decreased from(2.78±0.30)mmol/L to(1.78±0.43)mmol/L,and high-density lipoprotein increased from(1.25±0.05)mmol/L to(1.39±0.06)mmol/L.Conclusion Periodontitis patients with NAFLD can obtain good clinical efficacy through periodontal basic treatment,which not only significantly improves their periodontal status,but also improves their liver function and blood lipid level.Therefore,periodontal basic treatment may be one of the treatment approaches for periodontitis patients with NAFLD.