牙周炎患者正畸治疗前后龈沟液中弹性蛋白酶的变化

Changes of Elastase in Gingival Crevicular Fluid before and after Orthodontic Treatment in Patients with Periodontitis

目的:探讨牙周炎患者正畸治疗前后龈沟液中弹性蛋白酶的变化价值,希望为早期预测患者预后提供参考。方法:2016年12月到2019年10月选择在本院就诊的牙周炎患者68例作为研究对象,所有患者都给予正畸治疗,检测正畸治疗前后弹性蛋白酶、探诊深度(probing depth,PD)、出血指数(bleeding on probing,BOP)、附着丧失(attachment loss,AL)的变化,记录患者的病情变化、判定预后并进行相关性分析、影响因素分析。结果:所有患者完成治疗,对于正畸治疗的美观、固位、稳定性均满意。治疗后1个月与治疗后3个月患者的PD、BOP、AL都低于治疗前(P<0.05),治疗后3个月也低于治疗后1个月(P<0.05)。治疗后1个月与治疗后3个月患者的龈沟液弹性蛋白酶值都低于治疗前(P<0.05),治疗后3个月也低于治疗后1个月(P<0.05)。Spearman分析显示治疗前与治疗后3个月的龈沟液弹性蛋白酶变化差值与PD、BOP、AL变化差值存在显著正相关性(P<0.05)。多因素Logistic回归显示PD、BOP、AL变化差值作为影响龈沟液弹性蛋白酶变化差值的主要因素(P<0.05)。结论:牙周炎患者正畸治疗前后龈沟液中弹性蛋白酶水平显著下降,与患者的病情变化显著相关,也是反映与预测患者预后的重要指标。

Objective:To investigate the value of elastase in gingival crevicular fluid before and after orthodontic treatment in patients with periodontitis,it hope to provide reference for early prediction of patient prognosis.Methods:From December 2016 to October 2019,68 cases of patients with periodontitis in our hospital were selected as the research target.All patients were given orthodontic treatment,and the changes of elastase,Probing depth(PD),bleeding on probing(BOP),attachment loss(AL)at before and after orthodontic treatment were detected,and were to determine the patient's condition and prognosis,and they given correlation analysis and influencing factor analysis.Results:All patients were completed the treatment and were satisfied with the aesthetics,retention and stability of orthodontic treatment.The PD,BOP,AL gingival crevicular elastase values at 1 month after treatment and 3 months after treatment were lower than before treatment(P<0.05),and the 3 months after treatment were also lower than 1 month after treatment(P<0.05).The gingival crevicular elastase values at 1 month after treatment and 3 months after treatment were lower than before treatment(P<0.05),and the 3 months after treatment were also lower than 1 month after treatment(P<0.05).Spearman analysis showed that there were significant positive correlation between the difference in the change of sputum fluid elastase and the difference of PD,BOP and AL before treatment and 3 months after treatment(P<0.05).Multivariate logistic regression showed that the difference of PD,BOP and AL were the main factor affected the difference of eosinase change in gingival crevicular fluid(P<0.05).Conclusion:The level of elastase in gingival crevicular fluid of patients with periodontitis are significantly decreased before and after orthodontic treatment,which are significantly correlated with the patient's condition and are important indicators to reflect and predict the prognosis of patients.