牙周炎与脑小血管疾病的相关性研究进展

Research progress on the correlation between periodontitis and cerebral small vessel disease

脑小血管疾病(cerebral small vessel disease,CSVD)在中老年人群中发病率较高,被认为是导致痴呆、认知能力下降、步态异常以及中风的主要血管因素。其主要的病理生理机制为内皮功能障碍和血脑屏障的通透性增加。有证据表明,全身慢性炎症状态与CSVD进展相关,炎症反应可能通过损害内皮细胞破坏血脑屏障,从而成为脑小血管疾病的主要危险因素之一。牙周炎是一种由口腔微生物(如牙龈卟啉单胞菌)构成的牙菌斑生物膜作为始动因子、多种因素共同参与的常见口腔慢性感染性疾病,其所致的慢性炎症与多种系统性疾病的发生发展有关。研究表明,牙周炎所致的全身炎症状态可导致内皮功能障碍,可能与CSVD的发生机制密切相关。文章就牙周炎与CSVD相关性的研究进展做一阐述,以期为进一步研究两者之间的关联机制提供新思路。

Cerebral small vessel disease(CSVD)has a high prevalence in the middle-aged and elderly population and is considered a major vascular factor leading to dementia,cognitive decline,gait abnormalities,and stroke.Its main pathophysiological mechanism is endothelid dysfunction and brain blood-brain barrier.Evidence suggests that a systemic chronic inflammatory state is associated with CSVD progression and that the inflammation may disrupt the blood-brain barrier by damaging endothelial cells,thus becoming one of the major risk factors for CSVD.Periodontitis is a common chronic oral inflammatory disease in which plaque biofilm,composed mainly of oral microorganisms(e.g.Porphyromonas gingivalis),acts as the initiating factor,and multiple influencing factors are involved,and periodontitis-induced chronic inflammation is associated with the development of several systemic diseases.Studies have shown that the systemic inflammatory state due to periodontitis can lead to endothelial dysfunction,which may be closely related to the mechanism of CSVD.This paper reviews the current research progress on the correlation between periodontitis and CSVD,with the aim of providing new ideas for further research on the mechanism of the association between periodontitis and CSVD.