牙列缺失患者血清BGP、AKP、OPN水平与口腔种植修复术后种植体预后的关系

Relationship between serum BGP,AKP and OPN levels in patients with tooth lossand the prognosis of implants after oral implant restoration

目的 分析牙列缺失患者血清骨钙素(BGP)、碱性磷酸酶(AKP)、骨桥蛋白(OPN)水平与口腔种植修复术患者种植体预后的关系。方法 选择2020年3月至2022年9月在西安国际医学中心医院行口腔种植修复术的牙列缺失患者95例作为观察组,根据预后情况分为预后良好组(65例)和预后不良组(30例);另选择同期在该院体检的健康人员95例作为对照组。收集观察组患者一般资料,以及对照组和观察组治疗前后的空腹静脉血,检测血清BGP、AKP、OPN水平;采用Pearson相关分析血清BGP、AKP、OPN之间的相关性;采用多因素Logistic回归分析影响患者种植体预后的因素;绘制受试者工作特征曲线分析血清BGP、AKP、OPN预测口腔种植修复术患者种植体预后的临床价值。结果 观察组患者血清BGP、AKP水平明显低于对照组,而OPN水平明显高于对照组,差异均有统计学意义(P<0.05)。血清BGP与AKP呈正相关(r=0.158,P=0.030)、与OPN呈负相关(r=-0.309,P<0.001),血清AKP与OPN呈负相关(r=-0.600,P<0.001)。预后不良组患者血清BGP、AKP水平明显低于预后良好组,OPN水平明显高于预后良好组,差异均有统计学意义(P<0.05)。血清BGP、AKP为患者种植体预后良好的独立保护因素(P<0.05),血清OPN为患者种植体预后良好的独立危险因素(P<0.05)。血清BGP、AKP、OPN预测口腔种植体修复术患者种植体预后的曲线下面积(AUC)分别为0.820、0.753、0.808,3项指标联合检测的AUC为0.896,灵敏度为76.7%,特异度为90.0%,约登指数为0.667。结论 牙列缺失患者血清BGP、AKP、OPN水平明显异常,三者可能相互影响并存在相关性,3项指标是口腔种植修复术患者种植体预后不良的影响因素,早期联合检测上述3项指标对种植体预后具有较高的临床预测价值。

Objective To analyze the relationship between serum levels of boneglaprotein(BGP),alkaline phosphatase(AKP),osteopontin(OPN)and implant prognosis in patients with dentition loss after oral implant restoration.Methods Ninety-five patients with dentition loss who underwent dental implant restoration in Xi′an International Medical Center Hospital from March 2020 to September 2022,were selected as the observation group and subdivided into the good prognosis group(65 cases)and the poor prognosis group(30 cases)according to the prognosis of surgical treatment.During the same period,95 healthy individuals who took physical examination in the hospital,were selected as the control group.The general data of patients in the observation group were collected,while the fasting venous blood of the control group and the observation group before and after treatment was collected to detect the serum levels of BGP,AKP and OPN.Pearson correlation analysis was conducted to analyze the correlation among serum BGP,AKP and OPN.The prognostic risk factors of implants were analyzed by multivariate Logistic regression.Receiver-operating-characteristic curve was used to analyze the clinical value of serum BGP,AKP and OPN in predicting the prognosis of patients with oral implant restoration.Results The levels of serum BGP and AKP in the observation group were significantly lower than those in the control group,and the level of OPN in the observation group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Serum BGP was positively correlated with AKP(r=0.158,P=0.030)and negatively correlated with OPN(r=-0.309,P<0.001),while serum AKP was significantly negatively correlated with OPN(r=-0.600,P<0.001).The levels of serum BGP and AKP in the poor prognosis group were significantly lower than those in the good prognosis group,and the level of OPN in the poor prognosis group was significantly higher than that in the good prognosis group,the differences had statistical significance(P<0.05).Serum BGP and AKP were independent protective factors for good prognosis of patients with implants(P<0.05),and seurm OPN was independent risk factors for good prognosis of patients with implants(P<0.05).The area under the curve(AUC)of serum BGP,AKP and OPN to predict the prognosis of patients with oral implant restoration was 0.820,0.753 and 0.808,respectively.The AUC of combined test of the three indexes was 0.896,the sensitivity was 76.7%,the specificity was 90.0%and the Yoden index was 0.667.Conclusion The levels of serum BGP,AKP and OPN in patients with dentition loss are significantly abnormal,they may affect each other with correlation.The above 3 indexes are the influencing factors of poor prognosis in patients with dental implant repair,and early combined detection of them has high clinical value in predicting the prognosis of patients with oral implant repair.