阿尔茨海默病伴中重度牙周炎患者龈下菌群情况及与认知障碍程度的关系探究

Investigation on Subgingival Flora Situation of Patients with Alzheimer’s Disease Complicated with Moderate to Severe Periodontitis and Relationship with Cognitive Impairment

目的:探究阿尔茨海默病伴中重度牙周炎患者龈下菌群情况及与认知障碍程度的关系。方法:选取2019年10月-2021年12月福建省立医院南院收治的阿尔茨海默病伴中重度牙周炎患者为研究对象,其中40例重度认知障碍患者为A组,40例中度认知障碍患者为B组,40例轻度认知障碍患者为C组,另外选取40例无阿尔茨海默病的中重度牙周炎患者为D组。比较四组Shannon指数、Chaol指数、主要龈下菌群(齿垢密螺旋体、伴放线菌嗜血菌、中间普雷沃菌、牙龈卟啉单胞菌及福赛斯坦纳菌)相对含量,采用Pearson相关性分析上述研究指标与阿尔茨海默病伴中重度牙周炎患者认知障碍(MMSE评分)的关系。结果:四组Shannon指数、Chaol指数及龈下菌群(齿垢密螺旋体、伴放线菌嗜血菌、中间普雷沃菌、牙龈卟啉单胞菌及福赛斯坦纳菌)相对含量比较,差异均有统计学意义(P<0.001);且A组、B组及C组均低于D组(P<0.001)。Pearson相关性分析显示Shannon指数及Chaol指数与MMSE评分呈正相关,上述龈下菌群相对含量与MMSE评分呈负相关(P<0.05)。结论:阿尔茨海默病伴中重度牙周炎患者龈下菌群情况相对异常,且其与认知障碍程度有密切的关系。

Objective:To investigate the subgingival flora situation of patients with Alzheimer’s disease complicated with moderate to severe periodontitis and relationship with cognitive impairment.Method:The patients with Alzheimer’s disease complicated with moderate to severe periodontitis who treated in Fujian Provincial Hospital South Branch from October 2019 to December 2021 were chosen as the study object,40 patients with severe cognitive impairment were chosen as group A,40 cases with moderate cognitive impairment were chosen as group B,40 cases with mild cognitive impairment were chosen as group C,another 40 cases with moderate to severe periodontitis and without Alzheimer’s disease were chosen as group D.Then the Shannon index,Chaol index,rlative expression of main subgingival flora(Treponema dentinarum,Haemophilus actinomycetes,Prevotella intermedia,Porphyromonas gingivalis and Tannerella forsythensis)of four groups were compared,and the relationship between those indexes and cognitive impairment(MMSE score)of patients with Alzheimer’s disease complicated with moderate and severe periodontitis were analyzed with Pearson correlation analysis.Result:The Shannon index and Chaol index,rlative expression of main subgingival flora(Treponema dentinarum,Haemophilus actinomycetes,Prevotella intermedia,Porphyromonas gingivalis and Tannerella forsythensis)of four groups were compared,the differences were statistically significant(P<0.001);the results of group A,group B and group C were significantly lower than those of group D(P<0.001).Pearson correlation analysis showed Shannon index and Chaol index were positively correlated with MMSE score,and those subgingival flora were negatively correlated with MMSE score(P<0.05).Conclusion:Subgingival flora situation of patients with Alzheimer’s disease complicated with moderate to severe periodontitis are relatively abnormal,and they have close relationship with the cognitive impairment.