LLLT疗法联合盐酸米诺环素对重度牙周炎患者的疗效及对Arg1、STAT6表达的影响

Effect of LLLT therapy combined with minocycline hydrochloride on the expression of Arg1 and STAT6 in patients with severe periodontitis

目的 分析LLLT(低能量激光)疗法联合盐酸米诺环素对重度牙周炎患者精氨酸酶1(Arg1)、信号转导及转录激活蛋白6(STAT6)蛋白表达的影响。方法 选取2020年6月至2021年6月华北医疗健康集团峰峰总医院诊治的95例重度牙周炎患者,根据随机数字表法分为对照组(47例)和联合组(48例),对照组给予盐酸米诺环素单一治疗,联合组给予LLLT疗法、盐酸米诺环素联合治疗。分析两组临床疗效,并比较不良反应发生情况。采用酶联免疫吸附法检测单核细胞趋化蛋白-1(MCP-1)、龈沟液骨钙素(BGP)、可溶性细胞间黏附分子-1(sICAM-1)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平;对两组牙周指数[包括菌斑指数(PLI)、牙龈指数(GI)、出血指数(BI)、牙松动度(TM)评分]进行评估,采用实时荧光PCR法检测Arg1、STAT6蛋白表达情况。结果 治疗后,联合组患者PLI、GI、BI、TM评分及Arg1、STAT6、TNF-α、IL-6、hs-CRP水平降低,且联合组水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者MCP-1、sICAM-1水平降低,BGP水平升高,联合组MCP-1、sICAM-1水平较低于对照组,BGP水平较高于对照组,差异均有统计学意义(P<0.05)。联合组治疗总有效率(95.83%)高于对照组(80.85%),差异有统计学意义(P<0.05)。联合组不良反应总发生率(14.58%)高于对照组(12.77%),差异无统计学意义(P>0.05)。结论 LLLT疗法、盐酸米诺环素联合应用可改善重度牙周炎患者临床症状,减轻龈沟液内炎性反应,改善牙周指数,抑制Arg1、STAT6水平,不良反应较少,安全性高。

Objective To analyze the effect of low energy laser(LLLT) therapy combined with minocycline hydrochloride on the expression of arginase 1(Arg1) and signal transducer and activator of transcription 6(STAT6) protein in patients with severe periodontitis.Methods A total of 95 patients with severe periodontitis treated in Fengfeng General Hospital of North China Medical and Health Group and Kailuan General Hospital from June 2020 to June 2021 were randomly selected and divided into control group and combined group by random number table method.The control group was treated with minocycline hydrochloride alone, and the combined group was treated with LLLT and minocycline hydrochloride.The clinical efficacy was analyzed, and the incidence of adverse reactions between the two groups were recorded and compared.The levels of monocyte chemoattractant protein-1(MCP-1),osteocalcin in gingival crevicular fluid(BGP),soluble intercellular adhesion molecule-1(sICAM-1),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) and high sensitive C-reactive protein(hs-CRP)were detected by enzyme-linked immunosorbent assay;the periodontal indexes [including plaque index(PLI),gingival index(GI),bleeding index(BI),tooth movement(TM) scores] of the two groups were evaluated, and the protein expression levels of Arg1 and STAT6 were detected by real-time PCR.Results After treatment, the scores of PLI,GI,BI and TM and the levels of Arg1,STAT6,TNF-α,IL-6 and hs-CRP in the combined group were decreased, and the levels of these indicators in the combined group were lower than those in the control group, and the differences were statistically significant(P<0.05).After treatment, the levels of MCP-1 and sICAM-1 in the two groups were decreased, and the level of BGP was increased, the levels of MCP-1 and sICAM-1 in the combined group were lower than those in the control group, and the level of BGP was higher than that in the control group, and the differences were statistically significant(P<0.05).The total effective rate of combined group(95.83%) was higher than that of control group(80.85%),and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the combined group(14.58%) was higher than that in the control group(12.77%),and the difference was not statistically significant(P>0.05).Conclusion LLLT therapy combined with minocycline hydrochloride can improve the clinical symptoms of patients with severe periodontitis, reduce the inflammatory reaction in gingival crevicular fluid, improve periodontal indexes, inhibit the levels of Arg1 and STAT6,with less adverse reactions and high safety.