盐酸米诺环素联合碘甘油对牙周炎患者牙周参数、龈沟液炎性因子及骨代谢因子的影响

Effects of minocycline hydrochloride combined with lodine glycerin on periodontal indexes,inflammatory and bone metabolism factors in gingival crevicular fluid in patients with periodontitis

目的:探究盐酸米诺环素联合碘甘油对牙周炎患者牙周参数、龈沟液炎性因子及骨代谢因子的影响。方法:选取80例牙周炎患者为研究对象,依据治疗方式不同分为对照组和观察组,每组各40例。对照组予以碘甘油+基础治疗;观察组予以米诺环素+碘甘油+基础治疗,疗程均为4周。比较两组患者临床总有效率;治疗前后牙周致病菌、牙周参数[牙周袋探诊深度(PD)、临床附着丧失指数(CAL)、出血指数(BI)、菌斑指数(PLI)]、龈沟液中炎性因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-13(MMP-13)]和骨代谢因子[Ⅰ型前胶原氨基端前肽(PINP)、Ⅰ型胶原C端肽(CTX)、骨钙素(BGP)、降钙素(CT)]水平变化。结果:观察组临床总有效率高于对照组(P<0.05)。观察组治疗后龈下牙龈卟啉单胞菌及伴放线放线杆菌比例、牙周参数PD、CAL、BI、PLI和龈沟液中IL-6、TNF-α、MCP-1、MMP-13水平低于对照组(P<0.05);龈沟液中PINP、BGP水平高于对照组(P<0.05),CTX、CT水平低于对照组(P<0.05)。结论:盐酸米诺环素联合碘甘油及牙周基础治疗牙周炎可提高临床疗效,抑制牙周致病菌,缓解牙周症状,减轻炎症反应,改善骨代谢。

Objective:To explore the effects of minocycline hydrochloride combined with lodine glycerin on periodontal indexes,inflammatory and bone metabolism factors in gingival crevicular fluid in patients with periodontitis.Methods:80 patients with periodontitis were selected as the research object,and were divided into control group and observation group by different treatment methods,40 cases in each group.The control group was treated with lodine glycerin+periodontal initial therapy,and the observation group was treated with minocycline hydrochloride on the basis of the control group.After 4 weeks of treatment,the clinical total effective rate were compared between the two groups.The levels of periodontal pathogens,periodontal indexes[probing depth(PD),clinical attachment loss(CAL),bleeding index(BI),plaque index(PLI)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),monocyte chemotactic protein 1(MCP-1),matrix-metalloproteinases-13(MMP-13)],and bone metabolism factors[type I procollagen propeptide(PINP),type I collagen cross-linked C-telopeptides(CTX),bone gla protein(BGP),calcitonin(CT)]in gingival crevicular fluid were compared between the two groups before and after treatment.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Compared with the control group,the proportion of porphyromonas gingivalis,actinobacillus actinomycetes,periodontal indexes PD,CAL,BI,PLI and IL-6,TNF-α,MCP-1,MMP-13 in gingival crevicular fluid after treatment of the observation group were significantly lower(P<0.05).The gingival crevicular fluid levels of PINP and BGP in the observation group were significantly higher than those in the control group,while the levels of CTX and CT in the observation group were lower than those in the control group(P<0.05).Conclusion:Minocycline hydrochloride combined with lodine glycerin and periodontal initial therapy can significantly improve the clinical efficacy in the treatment of periodontitis,inhibit periodontal pathogens,relieve periodontal symptoms,reduce inflammatory reaction and improve bone metabolism.