唾液皮质醇水平和牙周状况与冠心病的关联性研究

Study on the correlation of salivary cortisol level and periodontal status with coronary atherosclerotic heart disease

目的探讨唾液皮质醇水平和牙周状况与冠心病(CHD)的关联性。方法选择2021年12月至2022年2月因胸痛、胸闷症状于安徽医科大学附属巢湖医院就诊的患者89例,根据冠脉造影检查结果将其分为CHD组(44例)和非CHD组(45例)。检查两组牙周情况,指标包括牙石指数(CI)、探诊出血指数(BI)、牙周探诊深度(PD)和附着丧失(AL)情况。比较两组口腔健康影响情况量表14(OHIP-14)评分和唾液皮质醇水平。结果CHD组PD、AL水平以及OHIP-14评分高于非CHD组,差异有统计学意义(P<0.05)。CHD组唾液皮质醇水平显著高于非CHD组[(9.75±1.63)nmol/L vs(7.41±1.22)nmol/L;t=8.286,P<0.001]。二元logistic回归分析结果显示,较高的唾液皮质醇、AL水平和OHIP-14评分是促进CHD发生的危险因素(P<0.05)。ROC曲线分析结果显示,唾液皮质醇具有诊断CHD的应用价值[AUC(95%CI)=0.893(0.830~0.956),P<0.001]。结论唾液皮质醇水平以及牙周健康状况与CHD的发生、发展存在关联性,较高水平的唾液皮质醇是促进CHD发生的危险因素。

Objective To investigate the correlation of salivary cortisol level and periodontal status with coronary atherosclerotic heart disease(CHD).Methods Eighty-nine patients admitted to Chaohu Hospital of Anhui Medical University from December 2021 to February 2022 due to chest pain and chest tightness were selected and divided into CHD group(44 cases)and non-CHD group(45 cases)according to the results of coronary angiography.The periodontal conditions including calculus index(CI),exploratory bleeding index(BI),exploratory periodontal depth(PD)and attachment loss(AL)were examined in the two groups.The Oral Health Impact Profile-14(OHIP-14)scores and salivary cortisol levels were compared between the two groups.Results The PD and AL levels and the OHIP-14 scores in the CHD group were higher than those in the non-CHD group,and the differences were statistically significant(P<0.05).The salivary cortisol level in the CHD group was significantly higher than that in the non-CHD group[(9.75±1.63)nmol/L vs(7.41±1.22)nmol/L;t=8.286,P<0.001].The results of binary logistic regression analysis showed that higher level of salivary cortisol,and higher scores of AL and OHIP-14 were the risk factors for CHD(P<0.05).The results of receiver operating characteristic(ROC)curve analysis showed that salivary cortisol had the application value in diagnosis of CHD[area under the curve(AUC)(95%CI)=0.893(0.830-0.956),P<0.001].Conclusion The level of salivary cortisol and periodontal health status are correlated with the occurrence and development of CHD,and the higher level of salivary cortisol is a risk factor for promoting the occurrence of CHD.