摘要
目的:分析血清热休克蛋白27(HSP27)、人软骨糖蛋白(YKL-40)与侵袭性牙周炎(Ag P)患者辅助性T细胞17(Th17)、调节性T细胞(Treg)的关系及对牙周-正畸联合治疗后预后的影响。方法:选取2020年5月-2022年4月河北北方学院附属第一医院收治的98例Ag P患者为Ag P组,另选取同期于医院检查的60例牙周健康志愿者作为对照组。采用酶联免疫法检测血清HSP27、YKL-40水平,流式细胞仪检测外周血Th17、Treg百分比,计算Th17/Treg比值;Pearson法分析血清HSP27、YKL-40与Th17、Treg细胞的相关性。Ag P患者经牙周-正畸联合治疗6个月后,复诊检查时根据牙周探针深度(PD)将患者纳入预后良好组(PD<4 mm)和预后不良组(PD≥4 mm)。采用Logistic回归模型分析Ag P患者牙周-正畸联合治疗后预后不良的影响因素。结果:Ag P组血清HSP27水平低于对照组,YKL-40水平高于对照组(P<0.05)。Ag P组外周血中Th17细胞百分比、Th17/Treg比值高于对照组,Treg细胞百分比低于对照组(P<0.05)。Pearson法显示,Th17细胞百分比、Th17/Treg比值与HSP27表达呈负相关,Treg细胞百分比与其呈正相关(P<0.05);Th17细胞百分比、Th17/Treg比值与YKL-40表达呈正相关,Treg细胞百分比与其呈负相关(P<0.05)。复查结果显示,预后良好患者共61例,预后不良共37例。预后良好组与预后不良组在患牙上下、前后分布、根形态、患牙PD最深值、牙槽骨高度、菌斑指数及HSP27、YKL-40水平方面比较差异有统计学意义(P<0.05)。Logistic回归显示,根形异常、患牙PD深、牙槽骨高度高、菌斑指数大、HSP27水平下降、YKL-40水平上升为Ag P患者牙周-正畸联合治疗后预后不良的危险因素(P<0.05)。结论:Ag P患者血清HSP27水平下降、YKL-40水平上升,与Th17、Treg细胞表达密切相关,是影响患者牙周-正畸联合治疗后预后不良的危险因素。
Objective:To analyze the relationship between serum heat shock protein 27(HSP27),human cartilage glycoprotein(YKL-40),helper T cells 17(Th17)and regulatory T cells(Treg)in patients with aggressive periodontitis(AgP)and the effect on prognosis after combined periodontitis-orthodontic treatment.Methods:98 patients with AgP who were admitted to the First Affiliated Hospital of Hebei North University from May 2020 to April 2022 were selected as AgP group,and another 60 volunteers with periodontal health who were examined in the hospital during the same period were selected as the control group.Serum HSP27 and YKL-40 levels were detected by enzyme-linked immunoassay.The percentage of Th17 and Treg in peripheral blood was detected by flow cytometry,and Th17/Treg ratio was calculated.The correlation of serum HSP27 and YKL-40 with Th17 and Treg cells were analyzed by Pearson method.After 6 months of combined periodontitis-orthodontic treatment,during the follow-up examination patients with AgP were included in the group with good prognosis(PD<4 mm)and the group with poor prognosis(PD≥4 mm)based on the periodontal probe depth(PD).The influencing factors of poor prognosis of patients with AgP after combined periodontitis-orthodontic treatment were analyzed by Logistic regression model.Results:The serum HSP27 level in the AgP group was lower than that in the control group,and the YKL-40 level was higher than that in the control group(P<0.05).The percentage of Th17 cells in peripheral blood and Th17/Treg ratio in the AgP group were higher than those in the control group,while the percentage of Treg cells was lower than that in the control group(P<0.05).Pearson method showed that the percentage of Th17 and Th17/Treg ratio were negatively correlated with HSP27 expression,while the percentage of Treg was positively correlated with HSP27 expression(P<0.05).The percentage of Th17 and Th17/Treg ratio were positively correlated with YKL-40 expression,while the percentage of Treg was negatively correlated with YKL-40 expression(P<0.05).Reexamination results showed that 61 patients had good prognosis,and 37 patients had poor prognosis.There were statistically significant differences between the good prognosis group and the poor prognosis group in the upper and lower of affected teeth,anterior and posterior distribution,root morphology,the deepest PD value of affected teeth,alveolar bone height,plaque index,HSP27 and YKL-40 levels(P<0.05).Logistic regression showed that abnormal root shape,deep PD of affected teeth,high alveolar bone height,large plaque index,decreased HSP27 level and increased YKL-40 level were risk factors for poor prognosis of patients with AgP after combined periodontitis-orthodontic treatment(P<0.05).Conclusion:The decrease of serum HSP27 level and the increase of YKL-40 level in patients with AgP are closely related to the Th17 and Treg cells expression,which are risk factors affecting the poor prognosis of patients after combined periodontitis-orthodontic treatment.
作者
肖金萍
胥爱文
王钟华
刘振丽
王蕊
王芹
XIAO Jin-ping;XU Ai-wen;WANG Zhong-hua;LIU Zhen-li;WANG Rui;WANG Qin(Department of Stomatology,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,075000,China)
出处
《现代生物医学进展》
CAS
2023年第14期2776-2780,2703,共6页
Progress in Modern Biomedicine
基金
河北省2021年度医学科学研究计划项目(20211453)。