重度牙周炎患者血清内脂素及前列腺素E2水平与治疗预后的关系分析

Relationship between serum levels of Visfatin and prostaglandin E2 and prognosis in patients with severe periodontitis after treatment

目的分析血清内脂素(Visfatin)及前列腺素E2(PGE2)水平与重度牙周炎患者预后的相关性。方法选取2020年1月至2023年1月郑州市口腔医院收治的102例前牙区重度牙周炎患者为调查对象,经牙周基础治疗3个月后,按照前牙区牙周袋探诊深度将所有患者分为预后良好组及预后不良组。比较预后良好组及预后不良组患者血清Visfatin、PGE2及基线资料间的差异,采用多因素logistic回归分析探讨患者预后不良的危险因素,采用受试者工作特征(ROC)曲线探讨血清Visfatin及PGE2水平在重度牙周炎患者预后中的预测价值。结果与预后良好组相比,预后不良组患者血清Visfatin及PGE2水平显著上升(P<0.001)。两组患者间性别、年龄、治疗前SBI及治疗前PLI均无显著差异(P>0.05);与预后良好组相比,预后不良组患者吸烟比例、治疗前PD及治疗前CAL显著升高(P<0.01)。多因素logistic回归结果显示吸烟、治疗前PD>7.65 mm,治疗前CAL>7.02 mm,血清Visfatin>83.96μg/L及血清PGE2>92.31 ng/L均是重度牙周炎患者预后不良的独立危险因素。ROC曲线分析结果显示血清Visfatin及PGE2联合预测重度牙周炎患者预后的AUC为0.973(P<0.001),灵敏度为96.15%,特异性为89.47%,95%CI为0.9469~0.9995,优于任何一个指标单独的预测效能。结论血清Visfatin及PGE2与重度牙周炎患者牙周基础治疗后的预后密切相关,Visfatin及PGE2联合检测可为临床重度牙周炎患者预后评估提供参考价值。

Objective To analyze the correlation between serum Visfatin and prostaglandin E2(PGE2)levels and prog⁃nosis in patients with severe periodontitis after treatment.Methods A total of 102 patients with severe periodontitis in the anterior dental area admitted to Zhengzhou Stomatological Hospital from January 2020 to January 2023 were selected as the investigation subjects.After 3 months of basic periodontal treatment,all the patients were divided into a good prognosis group and a poor prognosis group according to the depth of periodontal pocket exploration in the anterior dental area.The differences of serum Visfatin,PGE2,and baseline data between the good prognosis group and the poor prog⁃nosis group were compared.Multivariate logistic regression analysis was used to explore the risk factors of poor prognosis in patients with severe periodontitis.The predictive values of serum Visfatin and PGE2 levels in patients with severe pe⁃riodontitis were investigated by receiver operating characteristic(ROC)curve.Results Compared with the good progno⁃sis group,the serum Visfatin and PGE2 levels in the poor prognosis group were significantly increased(P<0.001).There were no significant differences in gender,age,pre-treatment SBI,and pre-treatment PLI between the two groups(P>0.05).Compared with the good prognosis group,the proportion of smoking,PD,and CAL before treatment were significantly increased in the poor prognosis group(P<0.01).Multivariate logistic regression showed that smok⁃ing,PD>7.65 mm before treatment,CAL>7.02 mm before treatment,serum Visfatin>83.96μg/L,and serum PGE2>92.31 ng/L were all independent risk factors for poor prognosis in patients with severe periodontitis.ROC curve analysis results showed that the AUC of serum Visfatin and PGE2 combined to predict the prognosis of patients with se⁃vere periodontitis was 0.973(P<0.001),the sensitivity was 96.15%,the specificity was 89.47%,and the 95%CI was 0.9469-0.9995,which was superior to the prediction efficacy of any single index.Conclusion Serum Visfatin and PGE2 were closely related to the prognosis of patients with severe periodontitis after basic periodontal treatment.The combined detection of Visfatin and PGE2 could provide reference value for the prognosis assessment of patients with se⁃vere periodontitis.