类风湿关节炎与慢性牙周炎相关性研究

Correlation Analysis between Rheumatoid Arthritis with Chronic Periodontitis

目的探讨类风湿关节炎(RA)与慢性牙周炎相关性。方法选取2020年11月—2021年4月就诊的RA 100例作为RA组,同期就诊的无RA病史和特殊口腔疾病100例作为对照组。比较RA组和对照组口腔相关指标和慢性牙周炎程度,分析RA患者慢性牙周炎程度与疾病活动度和炎性指标关系,探讨RA患者口腔相关指标与RA相关指标相关性。结果RA组临床附着水平(CAL)、探诊深度、探诊出血指数(BOP)阳性率、菌斑指数和患慢性牙周炎中重度所占比例均高于对照组(P<0.05或P<0.01);RA患者慢性牙周炎程度越重中高疾病活动度例数越多;正常或轻度慢性牙周炎RA患者C反应蛋白和红细胞沉降率低于或慢于中度或重度慢性牙周炎RA患者(P<0.05或P<0.01)。RA患者CAL与抗环瓜氨酸肽抗体呈正相关,BOP阳性率与抗环瓜氨酸肽抗体、红细胞沉降率、类风湿因子和疾病活动指数评分呈正相关(P<0.01)。结论RA患者牙周状况较无RA病史和特殊口腔疾病患者差,且中重度慢性牙周炎患病率较无RA病史和特殊口腔疾病患者高。RA可加重牙周组织破坏,慢性牙周炎会加速RA发生和发展,二者存在一定相关性。

Objective To investigate the correlation between rheumatoid arthritis(RA)with chronic periodontitis.Methods A total of 100 patients with RA treated between November 2020 and April 2021 were selected as RA group,while other 100 patients without histories of RA or special oral diseases treated at the same period were selected as control group.Dental parameters and the degree of chronic periodontitis were compared between two groups.Correlations between the degree of chronic periodontitis with disease activity and inflammatory indexes were analyzed,and correlations between dental parameters with RA-related indexes were explored in RA patients.Results Clinical attachment level(CAL),probing depth,positive rate of bleeding on probing(BOP)index,plaque index and the proportion of moderate to severe chronic periodontitis in RA group were significantly higher than those in control group(P<0.05 or P<0.01).The more serious the chronic periodontitis was,the more cases with high disease activity were;levels of C-reactive protein and erythrocyte sedimentation rate in patients with normal or mild chronic periodontitis RA were significantly lower than those in patients with moderate or severe chronic periodontitis RA(P<0.05 or P<0.01).CAL was positively correlated with anti-cyclic citrullinated peptide antibody,and positive rate of BOP was positively correlated with anti-cyclic citrullinated peptide antibody,erythrocyte sedimentation rate,rheumatoid factor and disease activity index in RA patients(P<0.01).Conclusion Patients with RA have worse periodontal conditions and higher prevalence rate of moderate to severe periodontitis compared with those in patients without history of RA and special oral diseases.RA can aggravate periodontal tissue destruction,and chronic periodontitis can accelerate the occurrence and development of RA.Therefore,there is a certain correlation between RA and chronic periodontitis.