口腔骨增量种植修复患者龈沟液PTX3、Nrg4水平与种植体预后的关系

The relationship between PTX3 and Nrg4 levels in gingival crevicular fluid and implant prognosis in patients with oral bone incremental implant repair

目的分析口腔骨增量种植修复患者龈沟液正五聚蛋白3(PTX3)、神经调节素-4(Nrg4)水平与种植体预后的关系。方法选取2021年4月—2022年4月华中科技大学同济医学院附属协和医院口腔科收治口腔骨增量种植修复患者92例为研究组,根据种植后1个月复诊时X线检查结果分为预后不良亚组56例,预后良好亚组36例;同期在医院体检牙周健康志愿者92例为健康对照组。采用酶联免疫吸附法(ELISA)法测定龈沟液PTX3、Nrg4的表达水平,Pearson相关性分析口腔骨增量种植修复患者龈沟液PTX3、Nrg4表达水平的相关性,Logistic回归分析影响骨增量种植修复患者种植牙预后的因素。结果与健康对照组比较,研究组CRP、TNF-α及龈沟液PTX3表达水平升高(t/P=30.695/<0.001、18.994/<0.001、8.383/<0.001),Nrg4表达水平降低(t/P=10.988/<0.001)。与预后良好亚组比较,预后不良亚组PTX3、CRP、TNF-α水平升高(t/P=4.706/<0.001、17.480/<0.001、9.410/<0.001),Nrg4表达水平降低(t/P=9.033/<0.001)。骨增量种植修复患者龈沟液PTX3和Nrg4表达水平呈负相关(r/P=-0.349/0.001)。Logistic回归分析显示,PTX3高、Nrg4低、CRP高是骨增量种植修复患者种植体预后的危险因素[OR(95%CI)=3.542(1.742~7.201)、2.524(1.121~5.682)、4.767(2.056~11.051)]。结论PTX3在口腔骨增量种植修复患者龈沟液中呈高表达,Nrg4呈低表达,二者与种植体预后相关。

Objective To analyze the relationship between the levels of positive pentameric protein 3(PTX3)and neuregulin-4(Nrg4)in gingival crevicular fluid(GCF)and the prognosis of implants in patients with oral bone incremental implant repair.Methods Ninety-two patients with oral bone augmentation implant repair admitted to the Department of Stomatology,Tongji Medical College Affiliated Hospital,Huazhong University of Science and Technology from April 2021 to April 2022 were selected as the research group.Based on the X-ray examination results at the follow-up one month after implantation,they were divided into a subgroup of 56 patients with poor prognosis and a subgroup of 36 patients with good prognosis;During the same period,92 periodontal health volunteers underwent physical examination in the hospital as a healthy control group.The expression levels of PTX3 and Nrg4 in gingival crevicular fluid were measured using enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to investigate the correlation between the expression levels of PTX3 and Nrg4 in gingival crevicular fluid of patients with oral bone augmentation implant repair,and logistic regression analysis was used to analyze the factors affecting the prognosis of dental implants in patients with bone augmentation implant repair.Results Compared with the healthy control group,the study group showed CRP,TNF-α,PTX3’s expression level in gingival crevicular fluid increased(t/P=30.695/<0.001,18.994/<0.001,8.383/<0.001),while the expression level of Nrg4 decreased(t/P=10.988/<0.001).Compared with the subgroup with good prognosis,the subgroup with poor prognosis’PTX3,CRP,TNF-αincreased(t/P=4.706/<0.001,17.480/<0.001,9.410/<0.001),while the expression level of Nrg4 decreased(t/P=9.033/<0.001).The expression levels of PTX3 and Nrg4 in gingival crevicular fluid of patients with bone augmentation implant repair were negatively correlated(r/P=-0.349/0.001).Logistic regression analysis showed that high PTX3,low Nrg4,and high CRP were risk factors for implant prognosis in patients with incremental bone implant repair[OR(95%CI)=3.542(1.742 to 7.201),2.524(1.121 to 5.682),4.767(2.056 to 11.051)].Conclusion PTX3 is highly expressed in the gingival crevicular fluid of patients with oral bone augmentation implant repair,while Nrg4 is low in expression,both of which are related to implant prognosis.